Saturday, October 30, 2010

Understanding Arthritis Treatment: Is there any cure?

I am sure most of us might have heard the word arthritis. Yes! it is one of the most common problems in all age groups though causes may vary. These days, the word arthritis is commonly used by layman for joint pain, but its meaning for medical professional may be little bit different.

Although many people perceive arthritis as a joint pain but in reality arthritis is an inflammation of joint, which may present with various symptoms and one of them is pain. The medical terminology for joint pain is arthralgia. As I stated arthritis is a common problem in all age group but causes can be drastically different. In general, an arthritis that affect children is called juvenile arthritis whereas all others are addressed with some additional word such as rheumatoid arthritis, osteoarthritis, autoimmune arthritis. Even though all these diseases contain the word arthritis, they are totally different diseases.

I must say that if you ever had arthritis, then you might recall joint pain, swelling, redness, increase local temperature and decrease joint movement. Yes, it is an awful moment and you certainly want to get rid of it as soon as possible. As with any other diseases, recovery from arthritis depends upon the severity and cause of arthritis. There are wide number of causes that can lead to arthritis ranging from trauma, infection, aging, autoimmune disease or systematic diseases. The most commonly used conservative measures to get rid of symptoms are rest, anti inflammatory pain meds, ice pack/heating pad. Even though most of the patients will have significant improvement with the above conservative measures, these treatment modalities do not cure arthritis permanently.

Unless we overcome the cause of arthritis and reverse the damage caused by it, it is not possible to cure arthritis. I think cure is an ultimate success for which we are struggling each day to reduce suffering of millions of people. The word cure can be only used for  a small proportion of arthritis caused by infection or systematic disease, if treated in early phase of disease people may recover completely without any residual problems. However, with advancing medical science and technology, we are able to offer a lot of treatment options which will take care of your problem. Depending upon the nature of problem, you may require regular medication or off and on treatment.

In cases of trauma and osteoarthritis, conservative measures are the 1st line of treatment and the majority of people will benefit from it. There are many other medications that are used for arthritis such as pain meds (Tramadol, Opiods, Tylenol), Nonsteroidal Anti-inflammatory drugs (Ibuprofen, Naproxen, Diclofenac), counterirritants (Menthol, Capsaicin), disease modifying drugs (Methotrexate, Hydroxychloroquine), biologics (Infliximab, Etanercept), and corticosteroid (prednisone, cortisone). In addition, physiotherapy is helpful in some of the cases. If none of these measures work, your doctor may suggest you for surgery.

Even though many people would try OTC anti inflammatory meds for arthritis, these drugs are associated with a lot of side effects and our major concerns are drug induced stomach ulcers. If you are required to take these meds for a longer time, then you are at risk. Recently, a new medication called celecoxib is approved by FDA for arthritis treatment. It is a selective COX 2 inhibitor and is rarely associated with stomach ulcers. Thus, I would encourage you to go for celecoxib as fas as GIT side effects are concerned. You can read more about celecoxib from click here.

Some other tips that are helpful in arthritis are weight reduction, regular exercise, and use of device (canes, walkers) to reduce stress on your joint. Even though we don't have cure at this time, but currently available treatment options have certainly minimized our suffering and disability to a certain extent. In near future, you may expect to see new treatment modalities which may cure arthritis.

Saturday, October 23, 2010

Do you really need a doctor visit for gastroenteritis?

Most of us might have encountered gastroenteritis once in our lifetime. Yes, this is a very common problem and affect millions of people in a year world wide. Although there are many possible causes for gastroenteritis ranging from viruses, bacteria, parasite and chemicals, but viral and bacterial causes are more predominant. You are more likely to get viral gastroenteritis if you eat or drink contaminated water or food, or share utensils, towels or food with infected person. By now, you already know that it is a contagious disease and can spread to other people.

I am sure some of you might have heard the term "stomach flu", this is just an alternative name for gastroenteritis. When you suffer from stomach flu, most likely you will develop watery diarrhea, abdominal cramps, nausea, vomiting, body aches and fever. Depending upon the severity of symptoms and amount of water and electrolyte loss, you may also develop signs of dehydration.

Good news is that most of the gastroenteritis are caused by viruses and typically antibiotics are not required. Even though you seem to develop a lot of symptoms in short time, but usually it does not last longer and the majority of people recover from it without any specific treatment.

In addition, you always need to know at what point you should consider doctor visit. There are many signs and symptoms but I will list some of them here for you: repeated vomiting for 48 hours, unable to drink liquid for 24 hours, fever greater than 104, blood in bowel movements, blood in vomitus, moderate to severe dehydration(dry mouth, increase thirst, yellow urine or decrease amount of urine, dizziness, lightheadedness, generalized weakness).

If you decide to visit your doctor, he/she may diagnose it based on your history, physical exam and test report. Generally, blood and stool tests are good enough to make final diagnosis. If the final conclusion is viral gastroenteritis, then all you need is rest, liquid and symptomatic treatment. Your doctor may suggest you to avoid eating and drinking for few hours to rest your stomach, encourage you to drink clear liquid, sprite, 7up, gatorade, and broths. After a while, you will start introducing soft diet and easy to digest food such as soda crackers, toast, gelatin, banana, rice and chicken. If you are a healthy person, then most likely you will recover form it without any complication in few days.

Thus, if you suffer from gastroenteritis symptoms don't panic, just follow the conservative measures and take rest. Try your best to maintain water and electrolyte balance to avoid dehydration. However, if you develop any alarming features stated above don't hesitate to see your doctor for proper evaluation and investigation. You can read more about it from this link, click here.

Sunday, October 17, 2010

Why should we care about PSA?

Many people are not clear about exact PSA guidelines and its importance in prostate cancer screening. The PSA stands for Prostate Specific Antigen and has a lot of health implications. PSA level is measured in blood and its normal reference range is below 4 nanograms. Whether PSA should be included in the routine screening is still debatable and the main reason behind this ambiguity is the lack of PSA screening to increase life span. Till now there is no consensus on a particular guideline which needs to be followed. You can read more about different guidelines put forward by various organizations from click here.

Again, the question is why should we care about PSA level if it is not helpful! Actually, it is not completely true; PSA has many other benefits that your physician want to consider based on your health status. There are many possible causes for increase in PSA level, some of them are prostate enlargement, prostate infection, prostate cancer, prostate biopsy, recent ejaculation, digital rectal exam, bicycle riding and aging. Yes, aging is one of the factors and PSA level increases as you age. Though there are many factors that can increase your PSA level, some of them causes temporary increase only but your physicians are particularly interested in repetitive persistent increase in PSA level because it is more reliable than a single spikes. A single spikes of PSA could be due to many minor issues and usually get back to normal as soon as you recover whereas repetitive increase suggest major concern in terms of prostate cancer and prognosis monitoring after prostate cancer treatment.

Thus, you can see that increase in PSA is not that alarming as compared to repetitive persistent increase. It is generally perceived that there is no added benefits of PSA screening after the age of 75 because prostate cancer is a slow growing tumour and it is not certain that PSA screening actually saves lives. However, major implication of PSA test is for people with family history of prostate cancer and for those undergoing prostate cancer treatment. Technically, PSA level play a vital role in monitoring cancer treatment efficacy and its relapse.

Although PSA screening is not mandatory at this time, but is it strongly recommended for someone at age 45-75 having increased risk for prostate cancer. However, its benefits in a sub population cannot be ignored.