A Brief Information About Colon-Rectal Cancer

The 12 feet human large intestine is divisible into two parts. Its first half constitutes the colon popularly referred to as the bowel. The second half constitutes the rectum and the following anal canal. The latter terminates into the anal opening which helps oust the excreta from the large intestine to outside the body. The primary function of rectum is to prepare the undigested food to be expelled out of the body. Persons having the genetic and medical history of cancer of the gastrointestinal tract or of the breast and ovary cancer have greater possibility to the risk for the same.

The inner most lining of the rectum wall is called mucosa. It contains glands that contribute to the secretion of mucus that helps lubricate the passage of stool. When the cancer is pertaining to the mucosa of any organ it is termed as adenocarcinoma. Colon-rectal cancer falls in the category of adenocarcinoma cancers. In this case the cancerous cells are initially benign or harmless and stay localized. They are manifested externally in the form of adenomatous polyp in the colon. However in course of time some of them turn malignant and begin spreading from the colon-rectum to the surrounding lymph nodes. Their spread is furthermore to other parts of the body through the blood stream and lymphatic channels to assault yet other organs of the body. This mechanism is referred to as metastasis. The malignant cells that have lost their normal control mechanisms are clumped together to form tumors. The line of treatment followed for this cancer depends upon how deeply the cancer has pervaded the rectal walls and the neighboring lymph nodes.

The colon-rectal cancer is visible externally by way of certain symptoms such as the

o Change in bowel habits in terms of its constituency, frequency and quality. It is either constipation or loose motions. There is feeling of insatiate excretion as if some thing still remains inside.

o Constricted stool referred to as ribbon stool.

o Blood in the stool.

o Chronic fatigue, anemia, weight loss for no reason.

o Uneasiness in passing bowels.

o Vomiting.

o Pelvic pain. In later stages of colon-rectal stool begins coming out of vagina also in case of females. In similar case in males air urine becomes a frequent feature.

Colon rectal cancer is caused due to

o Diet low in dietary fiber and high in saturated fats as red meats, butter, products made from refined/white flour, alcohol, diet low in selenium. It is low in green and colored veggies and fruits.

o Smoking

o Increased age

o Genetics/Family medical history of cancers of various organs.

o Physical inactivity

o Exposure to human papilloma virus.

Colon-Rectal cancer may be kept at bay by

o Improving dietary habits. It should be rich in soluble as well as insoluble fiber, whole grain bread, fresh fruits, green and colored veggies, fish, nuts, ample water, fresh air, sunshine and good sleep.

o Regular exercise and other forms of body activity.

o Eat only when actually hungry. Drink lots of water to flush toxics out of the body. Water also helps body adequately hydrated. It ensures metabolic activities to be performed efficiently.

o Increased fiber rubs the walls of intestine and brushes it off the metabolic toxic and several other micro-organisms which if allowed persisting may lead to conversion of benign forms to malignant cases in later stages.

Colonoscopy using endoscope is used to diagnose colon-rectal cancer. The line of treatment is surgery followed by chemotherapy.

Ovarian Cysts Size – Types and Sizes of Cysts in the Ovaries

There are many different types of cysts, that can form in the ovaries and they come in many different sizes.

An ovarian cysts size is important, because it may determine how you doctor decided to proceed with treatment. The following information will provide you with information on the various types of legions that can develop and what their average size is.

Functional Cysts

These are the most common types of legions found in the ovaries and they tend to be quite small at only 4-5 cm big. This includes both the corpus luteum and follicle cysts and without treatment they will commonly reabsorb by themselves in 6-8 weeks time. Because of their smaller size, they will often go unnoticed and no other course of treatment is generally needed.

Endometriotic Cyst

When you consider ovarian cysts size, these are generally some of the largest ones. An endrometriotic cyst is also known as a “chocolate” cyst because of the brown color of the old blood held within them. The can grow quite large and develop in individuals with endometriosis. This type of legion usually has to be removed surgically since they will not reabsorb on their own.

Malignant Cysts

These are the legions which become cancerous. They are almost always removed surgically because of their malignant nature, but not always because of their size. These cysts can be either large or small, but have to be removed from the body regardless of their size.

Ovarian cysts size plays a big role in determining how a doctor diagnoses and treats them. If your cyst is a normal small legion, it will more than likely be left to absorb on its own. However, if you have a large or cancerous cyst, it will have to be dealt with in a more thorough manner.

Looking For Baby Thrush Treatment? Treat Your Baby’s Thrush Using Baking Soda – Here’s How!

Welcome to the club of parenthood. Once upon a time you where responsible for only yourself, but suddenly you grew up and someone else depends on you for their everything. Wow! What a great responsibility that is…

Except that you did not bargain for infections like thrush! Well, no bother, it is part of the package. What is done is done – what way forward? Answer; seeking a solution to your baby’s thrush issues.

Thrush occurs as a direct result of fungal infection; the name of the fungus responsible for this is known as Candidiasis or Candida. It affects both the old and the young even though it occurs more commonly in children and infants.

You can identify it from the way it looks; white patches which appear in your child’s mouth (the roof, the gums, and the tongue). These patches look like cottage cheese and can be painful which may cause your baby to refuse food.

This article will look at how you can use a common home ingredient to create a home remedy for thrush. By the end of this article, you would have discovered how to utilize baking soda as an uber-effective thrush treatment for your baby; let’s get on with it…

Step #1 – Purchase a can of baking soda. This can be gotten from your local grocery store. Get some water and mix it with a measured quantity of the baking soda until the soda dissolves. Now you are ready to add the next item…

Step #2 – After you get your water and baking soda mixture, you will need to add a drop of dish soap to it and mix thoroughly. Now we move to the application…

Step #3 – You now have your solution and potential remedy concocted, therefore you are ready to apply it to the infected area. Before doing this, you should pour some of the mixture on a clean cloth.

Use the cloth to wipe the insides of your baby’s mouth. Ensure that you rub the affected areas including the tongue and the roof of the mouth. Next, discover how long this needs to go on…

Step #4 – Until you notice the complete receding of the thrush, you want to ensure that you continue the above process daily for four to six times. The question now is; what if you do not have baking soda?…

Step #5 – Vinegar can be used as a substitute for baking soda. Yeast cannot survive once you successfully alter the acidic levels in the mouth and either ingredient (the baking soda or vinegar) can achieve this.

Anything else worthy of note?…

Step #6 – Yep there is; after each feeding ensure that you treat your nipples with the same baking soda solution using a cotton swab. This will help both in deterring a resurgence of the infection to your child’s mouth and an occurrence of the same on your nipple.

Omega 3 Fish Oil and Liver Disease

In the human body, there are a number of organs that are arranged in systems in order to provide the body with different abilities. For example, the lungs and the trachea and nostrils all work together to allow for breathing as well as to transport oxygen to the blood. The nervous system is a setup of nerves that lead directly to the brain in order to relay messages to and front different parts of the body. The role of the liver is to help in the processing of different foods and toxins that accumulate in the body. While this might not sound as glamorous as other organs, without proper liver function, the body can experience fatal ramifications.

What is Liver Disease?

Liver disease occurs when the liver is not functioning properly. There are a number of reasons why this can happen: disease, cirrhosis, and physical damage. Sicknesses that begin to eat away at the cellular function in the body, like cancer, can begin to make it difficult for the liver to process things like cholesterol and toxins that a person might ingest. Liver cancer is one of the more lethal cancers that occur because the liver is such an important order. Cirrhosis of the liver that occurs because of disease or from years of heavy drinking causes the liver to harden and causes it to not be able to function properly as well. In the case of physical damage to the liver, it is sometimes not a permanent change in the liver function, but it can certainly cause troubles. The liver is, thankfully, the one organ that can regenerate itself, but it takes time to do so and can only happen when the patient is healthy.

When liver disease occurs, the body can begin to fill with toxins, much in the same way that kidney disease does the same thing. If the liver is unable to process cholesterol, the body’s cholesterol levels will be very high and this can lead to damage for the heart and circulatory system.

What are the Treatments for Liver Disease?

Depending on the severity of the liver disease case, there are several treatment options that are available to patients. One of the first possibilities is to remove the diseased portion of the liver and to allow a new liver to grow back in its place. This kind of surgery sounds easy, but it still carries the same risks that other surgeries carry – i.e. risk of infection, death, complications, etc. In a healthy individual, this can be a permanent fix for the liver disease, however. Another option is to perform a liver transplant. This is when a liver from a donor is inserted in the patient after the diseased liver is removed. This is another risky surgery that can cause problems for both the donor and the recipient. The patient that receives the liver will need to change their life dramatically in order to ensure that they don’t do any damage to their new liver. The patient will also need to be on anti-rejection drugs, possibly for life. These drugs can render their immune system weak and can lead to other problems.

Liver disease can sometimes be treated with drug therapies when the illness or cancer is too advanced, but these treatments are often just used as palliative care in terminal cases.

The best form of treatment for liver disease is prevention. Limiting the consumption of cholesterol, eating an overall balanced diet with produce, as well as drinking plenty of water to aid in digestion are all easy habits to start and to maintain. Another consideration is to limit the consumption of alcohol in order to prevent cirrhosis.

How Can Fish Oil Help Liver Disease?

In recent years, the usefulness of fish oil supplementation has been researched more fully. Because the fish oil supplement has already been linked with a reduction in inflammation in the body, it’s no surprise that the supplement might also be able to help the body in the case of liver disease. By helping the liver to reduce the inflammation of the cells during disease, this can aid in the healing of the liver.

Studies in the UK as well as through the University of Pittsburgh in the United States are both giving promising results, though a larger sampling will need to be done in the future. These studies have shown that in cases of liver cancer where the patients have been given fish oil supplements, the growth of the liver cancer has been slowed in contrast with the control group. What’s most fascinating about these studies is that results were seem within 48 hours of the administration of the fish oil.

Conclusion

Fish oil seems to be a good preventative measure in terms of dealing with current liver problems as well as preventing new ones. By taking fish oil supplements or adding two servings of fish a week to the diet, it’s simple to ensure that the liver is still performing its duties.

Persistent Lower Back Pain – A Possible Sign of Gall Bladder Disease

Gall bladder disease can generate a wide range of non-specific clinical manifestations in patients. Gall bladder disease sufferers usually experience differentiated symptoms according to their age and sex. Although gall bladder affections and problems can occur in both sexes, the female gender generally experiences more intense and diversified symptoms. The clinical manifestations of gall bladder disease are also influenced by the underlying causes of the illness and its stage of progression.

The gall bladder is a small organ situated in the close proximity of the liver, in the right upper region of the abdomen. Its main purpose is to aid the liver in the process of fat digestion, by collecting and storing bile, then releasing this substance inside the small intestine and stomach when necessary. Produced by the liver, bile has a vital role in the assimilation of vitamins A, D, E and K. The composition of bile consists of water, bile acids, phospholipids, electrolytes and pigments. Gall bladder disease can be either caused by chemical imbalances in the composition of bile (which results in thickening of bile, leading to the formation of gallstones), physiological dysfunctions at the level of the biliary system or gall bladder infections.

In the early stages of the disease, people with gall bladder affections rarely experience pain. At first, the disease generates symptoms such as abdominal bloating, indigestion, abdominal discomfort, nausea, vomiting and diarrhea. As the disease progresses, patients experience radiating pain in the region of the right upper abdomen, pain that eventually moves to the lower back side. Although lower back pain is not always very revealing for gall bladder affections, it is still considered to be an important criteria in the process of diagnosis. Recent studies have revealed the fact that gall bladder disease sufferers commonly experience lower back pain in more advanced stages of the illness. This symptom of gall bladder disease is mostly common in patients with ages over 50, rarely occurring in younger adults or children. Gall bladder back pain can be either the result of pronounced inflammation of the gall bladder or biliary colic.

Biliary colic is a common cause of lower back pain. Biliary colic refers to formation of gallstones inside the gall bladder and hepato-biliary ducts. Gallstones, also known as biliary calculi, are small stones formed from excess cholesterol, calcium and bile pigments. When gallstones accumulate in large amounts they can obstruct bile ducts completely, facilitating the occurrence of gall bladder infections. Associated with gall bladder inflammation and infections, biliary colic generates intense, persistent pain in the region of the lower abdomen and lower back. Gall bladder back pain usually occurs in episodes, each attack lasting from 20-30 minutes to a few hours.

The formation and accumulation of gallstones at the level of the biliary system is a common disorder, affecting more than 15 percent of people with ages over 50. Gallstones can be easily observed with the means of ultrasound tests and computerized tomography and patients can be quickly diagnosed with biliary colic. If you experience intense abdominal and back pain, associated with abdominal bloating, nausea and vomiting, it is best to see a doctor as soon as possible, in order to receive an appropriate medical treatment.

When Should I Induce Dog Vomiting?

Dogs are naturally curious creatures, and they will find their way to get into things that they shouldn’t. But, no matter what your dog has ingested the first step is always to call the vet.

It could be more dangerous if you try and induce vomiting without talking to an expert.

As a general guideline you should not induce vomiting if the dog is already vomiting, or if your dog is unconscious, having trouble standing or breathing.

If your dog has ingested bleach, drain cleaner or a petrolleum dissilate product you do not want it to vomit them up because they could burn your dog’s esophagus or mouth.

Finally, be aware of how much time has passed since your dog ingested the substance. If it has been over two hours, it is probably in the dog’s small intestine and can’t be vomited back up.

The only time it is OK to induce vomiting is if your vet tells you to or if your dog has ingested antifreeze within the past two hours.

How To Induce Vomiting

Now that you know when to induce vomiting here is how you do it.

First, it helps if your dog has a little food in its stomach, so give it a cracker, some bread or some dog food. Put some 3% hydrogen peroxide (you can also use ipecac) into a small bowl and use a 10 cc syringe to take in 3 cc’s of liquid for every 20 lbs (9 kg) of the dog’s weight.

Shoot a steady stream of liquid at the back of your dog’s throat.

If your dog has not started vomiting after 10 minutes give one more dose. If your dog still has not started to vomit or if your dog is vomiting uncontrollably do not give another dose, but call your vet immediately.

The Best Natural Remedies For Food Poisoning

Food poisoning is a common, but extremely unpleasant affliction. In most cases, food ailment is caused when a person ingests bacteria in their food. Ingesting these bacteria can cause nausea, vomiting, or general feelings of weakness. Even though it is common, few people know what to do when they are struck with a bout of poisoning. While there are some over the counter options that will help alleviate the symptoms, it is not necessary to take drugs to feel better. There are a number of natural remedies for food poisoning that many people swear by, some of which may already be in your home.

One of the most important things that should always be done in cases of poisoning that manifest with vomiting is to drink plenty of fluids. Staying hydrated is always an important element of good health, and it is doubly true when one’s body is trying to get over an illness. In addition to water, consider drinking herbal teas that will also serve to settle the stomach. Mint and green teas are good choices, as is the poor health stand-by chamomile. If you are drinking a number of cups for hydration, try to avoid teas that are caffeinated, as it will be harder to get the sleep you need to feel better.

There are a number of foods that will aid in digestion and act as a remedy for food poisoning. Cider vinegar is often cited as an ingredient in home remedies and it has worked for many people in cases of food issues as well. Cider vinegar will help cut down on the presence of acid in the stomach, which can lead to discomfort. Be careful not to drink more than a tablespoon or two, as too much vinegar can be irritating to the throat and the stomach.

Ginger is another great natural remedy food poisoning option. Ginger may be crushed into a cup of tea or water to help your body break it down more quickly. Most of the symptoms of food poisoning are cause by stomach inflammation, and ginger’s ability to lessen it will help you feel better more quickly.

Of course, the best way to treat poisoning from food is to avoid it. When you are cooking at home, make sure to use separate cutting boards for vegetables and raw meat. Always clean produce before eating it, and make sure that meat is cooked properly.

7 Ways to Treat Mouth Ulcers

Two most common causes of mouth ulcers are mechanically injury to mouth lining and the other is aphthous ulcer (canker sore) when a person is feeling stressed or under the weather.

Injury to the mouth can be from accidental biting the inside of the mouth, minor burns from hot food or drinks, or braces rub against the gums. The sore eventually become the common ulcer which can take between 7 to 10 days to heal.

Other more serious ulcers are herpes infection, autoimmune diseases, inflammatory bowel disease, skin disorder which usually accompanied by other symptoms.

Sometimes a deficiency in iron, vitamin B12 and folate can cause recurrent of mouth ulcer too. Some medications such as anti-thyroid drugs and cytotoxic agents may also be responsible for mouth ulcers.

Of course all ulcers will cause discomfort and can be painful at times. Therefore the goal of treatment is to alleviate the pain.

There are basically 7 methods is treating mouth ulcers:

  1. Apply topical gels, pastes or mouthwashes that contains anaesthetics, pain reliever, and anti-inflammatory substances. Many of this can be bought over the counter without prescription excluding those which contain a combination of control medicine.
  2. Painkillers such as paracetamol or ibuprofen can help to relieve the pain.
  3. Taking herbs such as Echinacea to build up your immune system.
  4. Use diluted chlorhexidine or other mouth antiseptic wash once a day to reduce the duration of the ulcers.
  5. Rinsing the mouth with iced water before a meal makes eating possible.
  6. Drinking cooled camomile tea.
  7. Gargling with warm salt water.

Most mouth ulcers heal on their own. But if they do last more than 3 week, please do consult your doctor or dentist.

If it comes with fever or other signs of illnesses, bigger than dime in diameter, or has uneven discoloration its better you consult a specialist.

You can prevent from having ulcers if you practice good dental hygiene. Regular visits to the dentist will certainly help. A healthy diet comprising vitamin C and B complex, iron and zinc will ensure a strong immune system to ward off infections.

If you are prone to recurrent ulcers, avoid using a hard tooth brush. A hard tooth brush may cause injury to your mouth and aggravate the pain. Use a soft tooth brush instead. You also want to avoid eating hard food or food with sharp edges.

Acid Reflux – Foods To Avoid And Acid Reflux Causes

If you’re looking for a natural cure for acid reflux or if you are just looking out for the acid reflux foods to avoid then perhaps you would first like to know a little more about it. Acid Reflux sometimes called GERD (Gastroesophageal Reflux Disease) or acid indigestion is a condition suffered by thousands of people from all walks of life. The main symptoms include frequent heartburn, a burning type of pain in the lower part of the mid chest, behind the breastbone, and sometimes in the mid abdomen.

So just what is Acid Reflux?

Acid Reflux is a condition in which acid from the stomach escapes and moves up into the esophagus. This is not a normal process of digestion and so can cause severe discomfort. If you have too much acid in your stomach it can eat away at the stomach lining and affect the muscles in the stomach and the esophagus.

Some of the more common acid reflux causes include diet and lifestyle. It may not be so easy to change your lifestyle, maybe because of the type of job you do, which may be hectic and stressful. However making a small change in your diet and knowing what acid reflux foods to avoid can make a huge difference to how much you suffer.

Watching what you eat is essential if you suffer from acid reflux, and knowing what acid reflux foods to avoid is vital, as a poor diet is one of the main acid reflux causes. And it’s not just what you eat; it can also be how you eat. Try eating smaller more frequent meals as opposed to large heavy meals. Having less food in your stomach at any one time, means that your stomach does not have to produce such a large amount of acid to digest it.

Natural remedies for acid reflux can include just eating the right foods, and knowing what acid reflux foods to avoid. Fatty foods, acidic foods such as oranges or tomatoes should all be avoided, as should onions, chocolate, and any milk based products. Fast foods and fried foods are known to be some of the worst acid reflux causes.

As well as acid reflux foods to avoid, there are also foods that can be beneficial (thank goodness I hear you cry). Try switching to more fruit and vegetables, and complex carbohydrates in your diet. Some of these beneficial foods include apples, bananas, carrots, rice (brown or white), bread (wheat, multi grain, or white), corn bread, pasta, and cereals.

Meat and fish can also be part of a healthy diet as long as they are cooked the right way. Avoid frying and always buy lean meats. Fish can be steamed and things like beef and pork can be grilled. Chicken breasts are fine as long as you remove the skin. Also some dairy products are ok, fat free cream cheese, soy cheese, or feta cheese will not cause you any problems.

Along with these acid reflux foods to avoid there are also certain drinks and beverages to be aware of. Coffee, tea, or anything else with caffeine should be avoided. Alcohol is another no no, as is milk or any milk products. Smoking is also one of the worst acid reflux causes, so the cigarettes will have to go if you want to start feeling some improvement. Just by making these few changes in your diet can act like a natural cure for acid reflux.

Natural Treatment for Heartburn

Heartburn happens to people once in a while, and keeping it away or reducing its occurrence requires a degree of discipline and determination. After all, even the most effective natural treatment for heartburn amounts to nothing if the simplest tips are not followed correctly and religiously.

For starters, eating properly is the first precept to remember. Food shaped with obtuse edges or are rough to the touch must be avoided as they can cause small wounds as they move from the mouth and through to the stomach for ingestion. These foods damage the lower esophageal sphincter, and as such, must be avoided.

Alcoholic beverages, including beer, gin, and wine, also hasten and worsen heartburns. A genuine natural treatment for heartburn works only when people refrain from alcoholic beverages and other acidic drinks, both natural (like orange and lemon juices) and artificial (like carbonated drinks).

Spicy food is also known to increase the likelihood of heartburn. Therefore, the third important step in a natural treatment for heartburn is to modify the different food items in the diet and completely avoid both spicy and acidic food.

Smoking may be bad for other health reasons, but it is also essential to purge and stop smoking. The natural treatment for heartburn requires not only putting an end to smoking, but also to avoid food and beverages that contain caffeine. Cutting down on coffee is essential in order to successfully apply the rules of this treatment.

The fifth thing to remember while the natural treatment for heartburn is underway is to slowly and completely chew food. This is an extremely important aspect of this treatment. Choose food that are easy to chew and swallow (like mash potatoes and scrambled eggs) and easily digestible food. Otherwise, prepare to chew heavily textured food very well. Doing this will help the body proceed in undertaking naturally treat heartburn as part of its usual processes of keeping the body healthy.

These tips may be easy to remember, but it also is easy to go astray in the middle of the treatment. As such, self-control and discipline are extremely important. The natural treatment for heartburn lasts for as long as is necessary for an individual person. Those who are treated faster are those who follow these tips, and may also be just physiologically-inclined to heal heartburn faster. Once healed, the person can return to eating normally, but again, in moderation. Others may take longer for treatment to become effective, especially when damage has been incurred in the process of repetitive heartburns.

Do not suffer any longer. Come over to my health blog and discover some effective yet simple natural treatments for heartburn today!

What Causes Stomach Gas – 3 Most Common Causes of Stomach Gas Problems

Have you been experiencing quite a bit of flatulence & were wondering what causes stomach gas? If so then today I will provide you with the 3 most common causes of stomach gas problems. You may be surprised to hear but it’s likely that if this is a chronic problem for you that it is being caused by a chronic underlying overgrowth or infection of something known as candida which I’ll get into at the end.

3 Common Causes of Stomach Gas

#1 – Too little Stomach Acid: This will come as a shock but when your body has too little stomach acid that’s when the problems start. Your stomach will reflex to either shoot the food out in order to prevent bacteria on the food from passing through your digestive system or it will churn and try to break it down without the acid. In either case it causes an upset stomach quite often, one easy solution to it is to avoid liquids entirely with meals as this only dilutes stomach acid further.

#2 – Lack of bowel movements: When you go less than 2 times per day you’re considered constipated believe it or not! What happens is the food sits in your intestines and begins to ferment and putrefy, this creates an excessive amount of gas which travels up the digestive tract back into the stomach or will apply pressure to the stomach and create tremendous bloating.

#3 – Candida Overgrowth: You may never have heard of this before but this yeast is likely inside your body causing havoc right now as it exists in over 90% of people. Although not always creating symptoms for everyone, this yeast can cause ongoing health problems if not addressed. One of the #1 symptoms it causes is excessive gas, the reason being that this fungus will grow inside your intestines and ferment, especially when there has been a lack of bowel movements even temporarily. It feeds on sugar as well so if you eat a diet of processed foods then you’re giving it exactly what it needs to grow further! The gas it creates is only one of many problems candida can cause such as anxiety, difficulty concentrating, allergies, IBS & other digestive problems and much more!

Boerhaave’s Syndrome – Know About This Rare Condition

Overview

The Boerhaave’s syndrome is a spontaneous perforation of the esophagus that usually affects the lower one-third of the food pipe. The condition was first described by a Dutch physician, Hermann Boerhaave in 1724. It is also known as ‘spontaneous esophageal rupture’. However, it is not truly spontaneous as it typically results from violent vomiting or retching. The word ‘spontaneous’ here denotes that the perforation is not caused by any foreign body or direct trauma.

It is a relatively rare condition. It is also likely to be under-reported as most of the cases are misdiagnosed or diagnosed only post-mortem. This is because the condition rarely presents with the classical picture. Most of the time, the patient seems like suffering from an abdominal or cardiac pathology while the real problem is in his food pipe.

Causes

The Boerhaave’s syndrome is often reported to be associated with overindulgence in food and alcohol. Such an activity is followed by violent vomiting against a closed glottis. This causes a sudden increase in the esophageal pressure and results in rupture.

Symptoms and presentations

The classical symptoms of the Boerhaave’s syndrome are:

  1. Vomiting
  2. Lower chest pain
  3. Subcutaneous emphysema – collection of air under the skin, especially the skin that covers the chest and neck.

This is called the ‘Mackler’s triad‘. But in most of the cases, the presentation is not classical.

A patient who presents with a history of overindulgence in food or alcohol followed by vomiting, severe chest pain, breathlessness and shock is likely to have a spontaneous esophageal rupture.

Other reported unusual presentations are changes in voice, extreme facial and neck swelling and thirst.

Complications

  1. During the later course of the disease, the patient can also present with infection of the mediastinum. This is the middle part of the chest cavity and it is prone to infection when any organ in this part of the chest cavity gets injured. The infection can also become full-fledged and spread to the blood causing sepsis.
  2. Pericarditis can occur. This is nothing but an infection of the pericardium which is the outermost covering of the heart.
  3. Air can get collected under the pericardium leading to a condition called pneumopericardium.
  4. Another possible complication is pneumoperitoneum, where air gets collected in the abdominal cavity.

These are rare but possible complications of this condition. Such unspecific presentations and complications are the main causes of delay in delivering relevant medical care to the patients. Hence the mortality rate is very high ranging from 20-40%. Spontaneous esophageal rupture is the most lethal gastrointestinal perforation.

Other conditions that mimic the Boerhaave’s syndrome

  1. The Boerhaave’s syndrome is commonly confused with peptic ulcer. But in this syndrome, a history of peptic ulcer and the usual symptoms of ulcer like heart burns and indigestion are absent.
  2. It is also common to mistake this condition for a heart attack. The crucial point is to differentiate the chest pain due to this syndrome from that of a heart attack because both the conditions need immediate medical intervention, but in entirely different ways.
  3. The third most common condition mimicking the Boerhaave’s syndrome is acute pancreatitis. This pancreatic disorder is also associated with alcohol consumption, vomiting and abdominal pain. Serum amylase is an enzyme secreted by the liver and the level of this enzyme is elevated in case of acute pancreatitis. This laboratory test differentiates acute pancreatitis from the Boerhaave’s syndrome.

Diagnosis

When a doctor suspects a spontaneous esophageal rupture in a patient, he demands for an erect chest X-ray film. A barium contrast study is also usually advised regardless of the inferences from an X-ray film. This radiological test can show where the perforation is located. If a perforation is present the radio-opaque barium ingested by the patient leaks out of the esophagus into the chest cavity. It can then be captured by X-ray films. If contrast studies are negative despite strong suspicion, the doctor then advises to perform a chest CT.

Management

The preferred treatment for spontaneous esophageal rupture is a surgical repair of the rupture. But the choice of the treatment and method of operative repair depends on various factors like:

  1. The size of the
  2. The site of the rupture
  3. Age of the patient
  4. General health condition of the patient
  5. The time lapsed from perforation to diagnosis.

Prolonged gastric (stomach) drainage and chest drainage with tubes may also be necessary. Survival rate and response to treatment depend mainly on early diagnosis and the appropriateness of the intervention.

Causes of Swollen Ankles in the Elderly

Many seniors complain of swollen ankles when they stand or sit for a long duration of time. Also, seniors who are obese suffer from this problem. Generally swollen ankles occur when there is fluid accumulated in the soft tissue present around the ankles and inside the ankle joints. Sometimes, the swelling can also occur due to a blood clot in the region. Certain medications like diuretics or laxatives can also cause the ankles to swell up.

In order to treat swollen ankles in seniors, it is important to first figure out why the swelling is occurring. There are certain health conditions that are common amongst seniors which cause ankles to swell up. Some of these health conditions are as follows:

Edema: This is health problem that is brought on due to poor blood circulation. The condition worsens with age as the blood vessels stop working normally and this leads to fluid getting retained in the intracellular spaces. Many times, it is considered to be an early symptom of kidney failure, liver failure or heart failure.

Gout: This condition is buildup of uric acid crystals in the joints of the ankles. Under normal circumstances, uric acid is a byproduct of digestion, but it is eliminated from the body. Sometimes, there is a problem with uric acid elimination and this leads to gout.

Arthritis: This health condition occurs with age as the cartilage in the joints and the joints themselves degenerate. Usually seniors who have rheumatoid arthritis suffer from swollen and inflamed ankles.

Vascular Obstruction: When the normal flow of blood is obstructed in the legs, it is known as vascular obstruction. This obstruction invariably is due to a clot and it causes the ankles and feet to swell up.

Congenital Heart Disease – Classification and Treatment

Congenital heart disease (CHD) refers to a defect in the structure and function of the heart and great vessels which is present at birth. They account for more deaths in the 1st year of life than any other birth defects. Some require urgent surgical correction, whilst others require careful follow-up, resolving spontaneously over time.

The embryonic development of the heart and great vessels is a very complex sequence of events. Any disruption in any part of this complex sequence can potentially result in a congenital heart defect.

Some CHDs may occur in isolation, whilst others may occur as part of various genetic syndromes, such as Down’s syndrome, Marfan syndrome, Turner syndrome and DiGeorge syndrome.

Types of Congenital Heart Disease:

CHD is often classified as being either cyanotic (where there is a blue discolouration due to a lack of oxygen in the blood) or non-cyanotic.

Cyanotic CHD:

• Tetralogy of Fallot

• Truncus arteriosus

• Transposition of the great vessels

• Tricuspid atresia

• Truncus arteriosus

• Hypoplastic left heart

• Pulmonary atresia

• Ebstein’s anomaly

Non-Cyanotic CHD:

• Ventricular septal defect (VSD)

• Atrial septal defect (ASD)

• Patent ductus arteriosus (PDA)

• Coarctation of the aorta

• Aortic stenosis

• Pulmonic stenosis

• Hypoplastic left heart

• Dextrocardia

Symptoms of Congenital Heart Disease:

The types and severity of symptoms depend largely on the type of defect present. Some conditions may present with symptoms at birth e.g. “blue baby”, difficulty breathing, weak cry, failure to thrive etc., whilst others may cause symptoms only in later life e.g. coarctation of the aorta. Others still, may not develop any symptoms and have normal physical activity and normal life span.

Treatment of Congenital Heart Disease:

This once again depends on the type and severity of the defect. Some CHDs improve spontaneously without the need for any treatment. Others are so small that no treatment may be required. The more serious defects, however, will generally require medication or surgical correction.

Pulmonary Heart Disease

This type of heart disease, one of many, sometimes develops as a result of a chronic lung infection, such as emphysema, asthma, and bronchiectasis, or a combination of these infections. Often there is also an association between pulmonary heart disease and silicosis, anthracosis. Boeck’s sarcoid, or any other condition producing scarring of lungs. The disease develops when there is an interruption in the normal circulatory flow between the heart and lungs, which creates a strain that eventually causes the right side of the heart to become enlarged.

An acute form of pulmonary heart disease can occur in the presence of a blood clot (pulmonary embolism) large enough to interfere seriously with circulation of blood in the lungs.

Less frequently, rapidly spreading lung cancer can cause this disease. Any other rapidly progressing infection of the lungs, such as tuberculosis and certain bacterial and fungus infections, can also pay a role.

Symptoms. The patient is short of breath, and coughs. The liver and heart become enlarged. The abdomen and feet swell and the fingers become clubbed. In addition, some patients complain of pain in the middle of the chest. On other occasions, when a patient exerts himself, there is dizziness and weakness.

Complications. Congestive heart failure is the main complication of this disease, and it is serious because it responds poorly to treatment. In this state, the right side of the heart enlarges, trying to overcome resistance to normal blood flow between the heart and lungs. Heart failure follows.

Prevention. Whatever is causing the interruption of normal circulatory flow between the heart and lungs must be dealt with first. Infections must be treated before they get beyond control.

In the case of heart failure, there is still hope for the patient if he is treated in accordance with the specific instructions of the physician.