Shortness of Breath 2

Shortness of Breath After Eating
Shortness of breath after eating may sound serious, but that's not always the case. You may experience this symptom if you
eat too quickly or too much. However, it could also be due to something serious, such as gastroesophageal reflux disease
(GERD) or bronchitis. .
6 Common Causes of Shortness of Breath After Eating
1. Eating Too Much or Too Quickly

Your stomach will become enlarged when you eat large meals or swallow food too quickly. You may also feel bloated, which
is usually the outcome of swallowing too much air while eating. You experience discomfort when your enlarged stomach
presses against your diaphragm, which in turn will make it difficult for you to breathe properly. Your diaphragm will have less
space to expand, but it will still have to give your body the same amount of oxygen, which makes you feel out of breath.
Simply, eat moderately and swallow your food slowly to avoid this issue.
2. Food Allergy
Eating something that you're allergic to will also lead to shortness of breath. You experience an allergy attack when your
immune system overreacts to a food or a substance in it. Although you may be allergic to any food, eight types of food are
usually the culprits in most cases. The list includes tree nuts, peanuts, eggs, wheat, milk, fish, shellfish and soy. Certain
seeds such as mustard seeds and sesame seeds may also trigger an allergy reaction.
Limiting exposure to these allergens or foods will effectively prevent shortness of breath.
3. Problems with Your Lungs or Airways

You may experience shortness of breath after eating if you have an underlying lung problem. Clogged airways due to
mucus or phlegm will make it difficult for air to move in and out of your lungs, which will make you feel breathless. You may
also feel breathless when you have an asthma attack. Using a spacer device with your regular asthma inhaler will help
deliver medicine directly to your lungs to relieve your symptoms.
Lung inflammation or pneumonia may also cause a cough and shortness of breath. Taking antibiotics is the way to deal with
such an infection. If you already have COPD, your breathlessness may indicate your condition is becoming worse. Other
serious causes of feeling breathless include tumors in the region of esophagus, trachea, etc.
Be sure to talk to your doctor to rule out the possibility of having any serious underlying lung problems.
4. Gastroesophageal Reflux Disease

GERD could also be a reason of shortness of breath after eating. It is a condition in which your lower esophagus opens too
often or stays partially open all the time. This allows your stomach acid and food to move back up from your stomach into
your esophagus. Experiencing this situation once in a while is not that serious, but you will be a patient of GERD if acid
reflux occurs more than twice a week. The condition causes several symptoms, including shortness of breath, especially
after eating anything. You may also experience a tight sensation in your lower chest as well as in your middle abdomen with
dry coughing, hoarseness, asthma and trouble swallowing.
The combination of medications and lifestyle changes will help keep symptoms in check.
5. Arrhythmia
It refers to an irregular heartbeat. The condition is quite common, but is usually harmless. It produces a number of different
symptoms, including shortness of breath right after eating. You may not notice any symptoms if you have mild arrhythmias,
but severe arrhythmias may cause specific symptoms, such as exhaustion, palpitation, lightheadedness, chest pain and
fainting. In some rare cases, arrhythmia may also lead to stopped heartbeat or cardiac arrest.
Treatment options include medications, surgery and altered lifestyle.
6. Anxiety Disorders
Anxiety disorders are types of psychological illnesses characterized by paranoia, fear, restlessness and panic. These signs
of anxiety disorders will make it difficult for you to function normally. You may notice different symptoms in different anxiety
disorders, such as obsessive-compulsive disorders, panic disorder, phobias and generalized anxiety, but shortness of
breath is a usually common symptoms of them. If your anxiety is associated with weight or other diet related problems,
meals may lead to shortness of breath and cause other symptoms such as nausea, lightheadedness, chest pain and
intense fear. Anxiety disorders usually come with other disorders this list includes anorexia and other mental illnesses,
such as bulimia, depression and binge eating.
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Your treatment options will depend on the severity of your symptoms and may include a combination of medications and
alternative therapies.
Note
You should seek immediate medical attention if along with shortness of breath after eating, you're experiencing other
symptoms such as coughing blood, heavy wheezing and fever higher than 101degrees Fahrenheit.
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Chest Breath Vs. Belly Breath Whats The Deal?
Breathing practices, called pranayama, are an important part of any yoga practice. So if you attend yoga classes, youre
guaranteed to hear the teacher instructing students to control the breath in a variety of ways, some more complicated than
others. The most common instructions that Ive encountered while taking yoga classes are breathe into your belly and
breathe into your ribs.
When I started doing yoga, I found myself confused about the mechanics of these two different actions, which never get
fully explained during class (through no fault of the teacher there simply isnt time). Rather than simply experiencing the
breathing exercise the teacher was offering, I often found myself thinking:
How? How on earth can air move into my belly? Air only goes in and out of the lungs, which are in the rib cage last I
checked. What am I missing?
It turns out the answer to that question is pretty simple.

Simple, that is, once you understand some basic principles of breathing, which can get very complicated very quickly. Ill
walk through some of these basics here in order to explain the difference between a chest breath and a belly breath.
Stick with me! And dont hesitate to ask questions.
The Breath Is Both Physiological And Experiential

First, its helpful to distinguish two ways that we can evaluate the concept of breathing.
1. The breath as a physiological process.
2. The breath as something we experience.
Sometimes these viewpoints align and sometimes they dont which can create major confusion.
Take this common instruction for example: Breathe into your belly.
From an experiential standpoint, this phrase makes sense and may even feel very intuitive. Most of us can feel the
abdomen rising and falling while we breathe. Focusing on drawing the breath down into the belly can help some individuals
breathe more deeply, smoothly, and/or consciously all things we generally want to encourage in yoga, which is why this
phrase gets used so often.
On the other hand, from an anatomical and physiological perspective, the instruction breathe into your belly is a little fuzzy
and potentially misleading. As I mentioned, when I started taking classes, I found myself wondering: If air only moves in and
out of the lungs, how can you breathe into your belly? What am I missing?
The Difference Between Air And Breath

One of the things I was missing is the distinction between the concept of air and that of breath. Air is the invisible gaseous
substance that moves in and out of the lungs through the bronchial tree during breathing (to be precise). While breath,
according to Leslie Kaminoff, can mean any type of movement . . . that accompanies respiration.(1)
So even though air doesnt move into the belly when we breathe, the breath does. This just goes to show how important
precision of language is while teaching... At least when you have literal thinkers like me in your class...
OK, so that clears it up somewhat but why exactly does the belly move when we breathe? To answer that question, lets
look at the diaphragm. Well get its anatomy out of the way first.
Anatomy Of The Diaphragm

The principal muscle of breathing is the diaphragm. It is shaped like a parachute or jellyfish and sits below the lungs. It is
tucked under the rib cage and it divides the torso into the thoracic and abdominal cavities.
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The outer edge of this parachute attaches to the sternum, the base of the rib cage and the front of the lower (lumbar)
spine. Together, these points of connection are referred to as the muscles origin.
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At the top of this parachute is a flat surface called the central tendon, made of non-contractile fibrous tissue. This means
that it does not contract on its own like a muscle. It can move but only when the muscle fibers that attach to it contract. The
central tendon is referred to as the diaphragms insertion.
The Diaphragm Contracts On Inhale And Relaxes On Exhale

When the diaphragm contracts, it changes the shape and, more importantly, increases the volume of the thoracic cavity.
This increase in volume results in a decrease in pressure within the cavity. This decrease in pressure causes air to flow into
the lungs. This is an inhale.
When the diaphragm relaxes, the lung tissues and thoracic cavity spring back to their original shape and volume, expelling
air out of the lungs. This is an exhale.
In a relaxed breath (like when we sleep), the exhale is passive meaning it occurs because muscles relax. That is not
always the case when we change or control our breathing while performing physical activities or pranayama (yogic
breathing) techniques.
The Movement Of The Diaphragm

The muscle fibers of the diaphragm are primarily oriented vertically (up and down).
This means that when it contracts, shortening its fibers, it pulls the central tendon (the insertion) and the base of the rib
cage (the origin) toward each other. The parachute starts to flatten itself out.
The movement of the breath is directed around the torso based on which part of the diaphragm (the origin or insertion) is
stabilized and which part is left free to move. This is the distinction between a chest breath and a belly breath that youve
been waiting for!
Chest Breath: The Central Tendon Is Stable And The Rib Cage Is Mobile
When the central tendon is held in place and the ribs are free to move, the base of the rib cage is lifted toward the central
tendon when the diaphragm contracts. This causes the rib cage and thoracic cavity to expand to the sides, front and back.
This is thought of as a chest breath.
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Belly Breath: The Rib Cage Is Stable And The Central Tendon Is Mobile
When the rib cage is held in place and the central tendon is free to move, the central tendon is pulled downward toward the
base of the rib cage when the diaphragm contracts. This presses down on the abdominal cavity.
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Weve already established that the thoracic cavity changes in shape and in volume during breathing, which is how air is
drawn into and expelled out of the lungs. The abdominal cavity, however, only changes in shape during breathing.
Leslie Kaminoff compares the abdominal cavity to a water balloon to make this point.(2) When you squeeze one end, the
other end bulges. The shape changes and the contents are shifted around but the volume stays the same. (Note that the
abdominal cavity can change in volume in other ways not associated with breathing, like when you eat a big meal or
become pregnant.)
When the diaphragm presses down on the abdominal cavity, making room for the thoracic cavity and thus lungs to expand,
the organs are essentially pushed out of the way and the belly bulges like a water balloon. This is thought of as a belly
breath.
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Every Breath Is A Diaphragmatic Breath
So there you have it. Once you understand the diaphragm as a muscle that can be stabilized on one end and allowed to
move on the other, the why behind chest and belly breathing becomes pretty straight-forward.
Its helpful to note that the scenarios described above are the two extremes. They can happen independently or they can
both happen at the same time to varying degrees. It depends on the activity of two groups of muscles called the accessory
muscles of respiration and the postural stabilization muscles in the torso.
One last thing Id like to emphasize is that the diaphragm is always acting when we breathe. Youll sometimes hear belly
breathing referred to as diaphragmatic breathing, implying that youre not using your diaphragm if you breathe into your
ribs, but in fact every breath is a diaphragmatic breath. Ones breathing pattern might be efficient or inefficient, but it always
involves the contraction (on inhale) and relaxation (on exhale) of the diaphragm.
Summary
The diaphragms main function is to draw air into the lungs by increasing the volume of the thoracic cavity. It does this in
two ways:
1. The diaphragm lifts the base of the rib cage and sternum, expanding the rib cage to the front, sides and
back, creating a chest breath.
2. The diaphragm presses downward on the abdominal cavity, which bulges forward, creating a belly breath.
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Whats Causing My Abdominal Bloating and Shortness of Breath?
Abdominal bloating occurs when the abdomen feels tight or full. This may cause the area to appear visually larger. The
abdomen may feel hard or tight to the touch, and can cause discomfort and pain. Shortness of breath is difficulty breathing.
Its the... Read more
21 Possible Causes of Abdominal Bloating and Shortness of Breath
Chronic Obstructive Pulmonary Disease (COPD)
Pregnancy
Congestive Heart Failure (CHF)
Hyperventilation
Ascites
Obesity
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Anxiety or Panic Disorder
Lactose Intolerance
Irritable Bowel Syndrome (IBS)
Menstruation
Hiatal Hernia
Gallstones
Hernia
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Ovarian Cancer
Pancreatic Insufficiency
Non-Hodgkin's Lymphoma
Cystic Fibrosis
Peripheral Neuropathy
Legionnaires' Disease
Polio
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Celiac Disease
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Chronic Obstructive Pulmonary Disease (COPD)
1. What is COPD?
Chronic obstructive pulmonary disease, or COPD, is a group of progressive lung diseases. The most common are
emphysema and chronic bronchitis. Many people with COPD have both of these conditions.
Emphysema slowly destroys air sacs in your lungs, which interferes with outward air flow. Bronchitis causes
inflammation and narrowing of the bronchial tubes, which allows mucus to build up.
COPD makes it harder to breathe. Symptoms may be mild at first, beginning with coughing and shortness of breath. As
it progresses, it can become increasingly difficult to breathe.
You may experience wheezing and tightness in the chest. Some people with COPD have exacerbations, or flare-ups of
severe symptoms.
The top cause of COPD is smoking. Long-term exposure to chemical irritants can also lead to COPD. Its a disease that
takes a long time to develop.
Diagnosis usually involves imaging tests, blood tests, and lung function tests.
Theres no cure for COPD, but treatment can help ease symptoms, lower the chance of complications, and generally
improve quality of life. Medications, oxygen therapy, and surgery are some forms of treatment.
Untreated, COPD can lead to heart problems and worsening respiratory infections.
About 24 million people in the United States have COPD. As many as half are unaware that they have it.
2. What are the symptoms of COPD?

At first, symptoms of COPD can be quite mild. You might be inclined to dismiss them as a cold.
Early symptoms include:
occasional shortness of breath, especially after exercise
mild but recurrent cough
needing to clear your throat often, especially first thing in the morning
You might start making subtle changes, such as avoiding stairs and skipping physical activities.
Symptoms can get progressively worse and harder to ignore. As the lungs become more damaged, you may
experience:
shortness of breath, after even mild exercise such as walking up a flight of stairs
wheezing, or noisy breathing
chest tightness
chronic cough, with or without mucus
need to clear mucus from your lungs every day
frequent colds, flu, or other respiratory infections
lack of energy
In later stages of COPD, symptoms may also include:
fatigue
swelling of the feet, ankles, or legs
weight loss
Immediate medical care is needed if:
you have bluish or gray fingernails or lips, as this indicates low oxygen levels in your blood
you have trouble catching your breath or cannot talk
you feel confused, muddled, or faint
your heart is racing
Symptoms are likely to be much worse if you currently smoke or are regularly exposed to smoke.
3. What causes COPD?

In developed countries like the United States, the single biggest cause of COPD is cigarette smoking. About 90
percent of people who have COPD are smokers or former smokers. Among smokers, 20 to 30 percent develop COPD.
Many others develop lung conditions or have reduced lung function.
Most people with COPD are over 40 years old and have at least some history of smoking. The longer you smoke, the
greater your risk of COPD is. In addition to cigarette smoke, cigar smoke, pipe smoke, and secondhand smoke can
cause COPD.
Your risk of COPD is even greater if you have asthma and smoke.
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You can also develop COPD if youre exposed to chemicals and fumes in the workplace. Long-term exposure to air
pollution and inhaling dust can also cause COPD.
In developing countries, along with tobacco smoke, homes are often poorly ventilated, forcing families to breathe fumes
from cooking and heating fuel.
There may be a genetic predisposition to developing COPD. Up to 5 percent of people with COPD have a deficiency in
a protein called alpha-1-antitrypsin. This deficiency causes the lungs to deteriorate and also can affect the liver. There
may be other genetic factors at play as well.
COPD isnt contagious.
4. Diagnosing COPD
Theres no single test for COPD. Diagnosis is based on symptoms, a physical exam, and test results.
When you visit the doctor, be sure to mention all of your symptoms. Tell your doctor if:
youre a smoker, or have smoked in the past
youre exposed to lung irritants on the job
youre exposed to a lot of secondhand smoke
theres a family history of COPD
you have asthma or other respiratory conditions
you take over-the-counter or prescription medications
During the physical exam, your doctor will use a stethoscope to listen to your lungs as you breathe. Based on all this
information, your doctor may order some of these tests to get a more complete picture:
A spirometry is a noninvasive test to assess lung function. During the test, youll take a deep breath and then blow
into a tube connected to the spirometer.
Imaging tests include a chest X-ray or CT scan. These images can provide a detailed look at your lungs, blood
vessels, and heart.
An arterial blood gas test involves taking a blood sample from an artery to measure your blood oxygen levels.
These tests can determine if you have COPD, or perhaps some other condition, such as asthma or heart failure.
5. Treatment for COPD

Treatment can ease symptoms, prevent complications, and generally slow disease progression. Your healthcare team
may include a lung specialist (pulmonologist) and physical and respiratory therapists.
Medication
Bronchodilators are medications that help relax the muscles of the airways so you can breathe easier. Theyre usually
taken through an inhaler. Glucocorticosteroids can be added to reduce inflammation in the airways.
To lower risk of other respiratory infections, ask your doctor if you should get a yearly flu shot, pneumococcal vaccine,
and a tetanus booster that includes protection from pertussis or whooping cough.
Oxygen therapy
If your blood oxygen levels are low, you can receive oxygen through a mask or nasal prongs to help you breathe better.
A portable unit can make it easier to get around.
Surgery
Surgery is reserved for severe COPD or when other treatments have failed, which is more likely when you have
emphysema. One type of surgery is called bullectomy. Thats when surgeons remove large air sacs (bullae) from the
lungs. Another is lung volume reduction surgery, which removes damaged lung tissue.
Lung transplant is an option in some cases.
Lifestyle changes
Certain lifestyle changes may also help alleviate your symptoms or provide relief.
These include:
If you smoke, quit. Your doctor can recommend appropriate products or support services.
Whenever possible, avoid secondhand smoke and chemical fumes.
Get the nutrition your body needs. Work with your doctor or dietician to create a healthy eating plan.
Talk to your doctor about how much exercise is safe for you.
6. Medication for COPD

Medications can reduce symptoms and cut down on flare-ups. It may take a bit of trial and error to find the medication
and dosage that works best for you. These are some of your options:
Bronchodilators
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Medicines called bronchodilators help loosen tight muscles around your airways. They are typically taken through an
inhaler or nebulizer.
Short-acting bronchodilators last from four to six hours. You only use them when you need them. For ongoing
symptoms, there are long-acting versions you can use every day. They last about 12 hours.
Some bronchodilators are beta-agonists. They work by relaxing tightened muscles around the airways. Some are
anticholinergics. They prevent muscle tightening and clear mucus from the lungs. Anticholinergics can also be taken
with a nebulizer.
Corticosteroids
Sometimes bronchodilators are combined with inhaled glucocorticosteroids. Using the two together can reduce
inflammation in the airways and lower mucus production. Corticosteroids are also available in pill form.
Phosphodiesterase-4 inhibitors
This newer medication in pill form reduces inflammation and changes mucus production. Its generally prescribed for
severe COPD.
Theophylline
This medicine eases chest tightness and shortness of breath. It may help prevent flare-ups. Its available in pill form.
Antibiotics and antivirals
Antibiotics or antivirals may be prescribed when you develop respiratory infections.
Vaccines
COPD increases your risk of other respiratory problems. For that reason, your doctor might recommend that you get a
yearly flu shot, the pneumococcal vaccine, or the whooping cough vaccine.
7. Diet recommendations for people with COPD

Theres no specific diet for COPD, but a healthy diet is important for maintaining overall health. The stronger you are,
the more able youll be to prevent complications and other health problems.
Choose a variety of nutritious foods from these groups:
vegetables
fruits
grains
protein
dairy
Drink plenty of fluids. Drinking six to eight 8-ounce glasses of noncaffeinated liquids a day can help keep mucus on the
thin side. This may make the mucus easier to clear out. Limit caffeinated beverages because they can interfere with
medications and increase water loss. If you have heart problems, you may need to drink less, so talk to your doctor.
Go easy on the salt. It retains water, which can strain breathing.
Weight matters. It takes more energy to breathe when you have COPD, so you might need to take in more calories. If
youre overweight, your lungs and heart may have to work harder. If youre underweight or frail, even basic body
maintenance can become difficult. Overall, having COPD weakens your immune system and decreases your ability to
fight off infection.
A full stomach makes it harder for your lungs to expand, leaving you short of breath. If that happens, try these
remedies:
Clear your airways about an hour before a meal.
Swap three meals a day for five or six smaller meals.
Save fluids until the end so you feel less full during the meal.
8. Living with COPD

COPD requires lifelong disease management. That means following the advice of your healthcare team. Theres a lot
you can do on your own, too.
Remember, your lungs are weakened. Youll want to avoid anything that might overtax them or cause a flare-up.
Number one on the list of things to avoid is smoking. If youre having trouble quitting, talk to your doctor about smoking
cessation programs. Try not to be around secondhand smoke, chemical fumes, air pollution, and dust.
A little exercise each day can help you stay strong. Talk to your doctor about how much exercise is good for you.
Maintain a diet of nutritious foods. Avoid highly processed foods that are loaded with calories and salt but lack nutrients.
If you have other chronic diseases along with COPD, it is important to manage those as well, particularly diabetes and
heart disease.
Clear the clutter and streamline your home so that it takes less energy to clean and do other household tasks. If you
have advanced COPD, get help with daily chores.
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Be prepared. Carry your emergency contact information with you and post it on your refrigerator. Include information
about what medications you take, as well as the doses. Program emergency numbers into your phone.
It can be a relief to talk to others who understand. Consider joining a support group. The COPD Foundation provides a
comprehensive list of organizations and resources for people living with COPD.
9. What are the stages of COPD?

One measure of COPD disease is by stage. The stages are:
Stage 0 At risk: Symptoms include coughing and noticeable mucus. You dont actually have COPD, so treatment isnt
necessarily needed. But do heed the warning. If you smoke, stop now. It would be wise to reassess your diet and
exercise routines to improve overall health. Once you have COPD, its not reversible or curable.
Stage 1 Mild: At this stage, some people still dont notice symptoms, which may include chronic cough and increased
mucus production. If you visit a doctor at this point, chances are youll start using a bronchodilator as needed.
Stage 2 Moderate: Symptoms are becoming more noticeable. In addition to the cough and mucus, you may start to
experience shortness of breath. You may need a long-acting bronchodilator.
Stage 3 Severe: Symptoms become more frequent and you may have occasional flare-ups of severe symptoms. You
might find that its difficult to function normally. Your doctor may recommend corticosteroids, other medications, or
oxygen therapy.
Stage 4 Very severe: Symptoms are progressing and its harder to complete everyday tasks. Flare-ups can be life-
threatening. You may be a candidate for surgical treatment.
As the disease progresses, youre more susceptible to complications, such as:
respiratory infections, including colds, flu, and pneumonia
heart problems
high blood pressure in lung arteries
lung cancer
depression
10. Is there a connection between COPD and lung cancer?

All around the world, COPD and lung cancer are major health problems. These two diseases are linked in a number of
ways.
COPD and lung cancer have several common risk factors. Smoking is the number one risk factor for both diseases.
Both are more likely if you breathe secondhand smoke, or are exposed to chemicals or other fumes in the workplace.
There may be a genetic predisposition to developing both diseases. Also, the risk of developing either COPD or lung
cancer increase with age.
Between 40 and 70 percent of people with lung cancer also have COPD. A 2009 study concluded that COPD is,
indeed, a risk factor for lung cancer.
A 2015 study suggests they may actually be different aspects of the same disease, and that COPD could be a driving
factor in lung cancer.
In some cases, people dont learn they have COPD until theyre diagnosed with lung cancer.
Of course, having COPD doesnt necessarily mean youll get lung cancer. You do have a higher risk though. Thats
another reason why, if you smoke, quitting is a good idea.
11. COPD statistics

Worldwide, about 65 million people have moderate to severe COPD. About 12 million adults in the United States have a
diagnosis of COPD. Its estimated that 12 million more have the disease, but dont know it yet.
Most people with COPD are 40 years of age or older.
The majority of people with COPD are smokers or former smokers. Smoking is the most important risk factor that can
be changed. Between 20 and 30 percent of chronic smokers develop COPD.
Between 10 and 20 percent of people with COPD have never smoked. In up to 5 percent of people with COPD, the
cause is a genetic disorder involving low levels of a protein called alpha-1-antitrypsin.
COPD is a leading cause of hospitalizations in industrialized countries. In the United States, COPD is responsible for
over 700,00 hospital admissions per year and over 1.5 million emergency department visits. Among people with lung
cancer, between 40 and 70 percentalso have COPD.
About 120,000 people die from COPD each year in the United States. Its the third leading cause of death in the United
States. More women than men die from COPD each year.
It is projected that the number of COPD cases will increase by more than 150 percent from 2010 to 2030. Much of that
can be attributed to an aging population.
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12. Whats the outlook for people with COPD?
COPD tends to progress slowly. You may not even know you have it during the early stages.
Once you have a diagnosis, youll need to start seeing your doctor on a regular basis. Youll also have to take steps to
manage your condition and make the appropriate changes to your daily life.
Early symptoms can be managed, and certain lifestyle choices can help you maintain a good quality of life for some
time.
As the disease progresses, symptoms can become increasingly limiting.
In severe stages of COPD, you may not be able to care for yourself without assistance. Youre at increased risk of
developing other respiratory infections, heart problems, and lung cancer. You may also be at risk of depression.
COPD generally reduces life expectancy, though the outlook varies considerably from person to person. People with
COPD who never smoked may have a modest reduction in life expectancy, while former and current smokers are likely
to have a larger reduction.
Besides smoking, your outlook depends on how well you respond to treatment and whether you can avoid serious
complications. Your doctor is in the best position to evaluate your overall health and give you an idea about what to
expect.
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Pregnancy?
Pregnancy occurs when a sperm fertilizes an egg after it is released from the ovary during ovulation. The fertilized egg then
travels down into the uterus, where implantation occurs. A successful implantation results in pregnancy. On average, a full-
term pregnancy lasts 40 weeks. There are many factors that can affect a pregnancy. Women who receive an early
diagnosis and prenatal care are more likely to experience a healthy pregnancy and give birth to a healthy baby. Knowing
what to expect during the full pregnancy term is also important for monitoring your health and the health of the baby. If you
would like to prevent pregnancy, there are also effective forms of birth control to keep in mind. .. Read more
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Concerns & Tips for the Third Trimester
As your due date approaches, many new questions will arise. Find the answers to common questions here
Pain & Insomnia During the Third Trimester

Pain and insomnia is a common result of the stress your body is under. Manage these uncomfortable symptoms
Skin Changes in the Third Trimester

Stretch marks aren't the only thing you may notice. Learn about skin changes that happen in the third trimester
Shortness of Breath & Edema

Swollen ankles and shortness of breath are common. Know when your symptoms require a doctor's attention
Symptoms of the Third Trimester

Weight gain, urine leakage, and hemmorrhoids: Read about typical symptoms in the third trimester
I Want to Prepare for Delivery
What to Expect During a Cesarean Section

A C-section is an operation performed by an obstetrician to deliver a baby. Understand what happens during this
surgery
ECV: Keeping the Fetus out of a Breech Position

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Some fetuses will not face the right direction before delivery. Discover how doctors keep fetuses in the correct
position
The Process of Vaginal Delivery

Every delivery is as unique and individual as each mother and infant. Learn about the typical delivery experience
What Causes Preterm Labor?

A baby born before the 37th week is known as preterm. Find out why preterm delivery happens
Developing a Birth Plan

Planning ahead for your delivery is important. Explore your doctor and birthing options
Stages of Labor
The process of labor and delivery can occupy the minds of expectant parents the most. Know what happens
during this process
Decisions to Make Before Your Labor

Giving birth is about more than just having a baby. Understand what decisions you should make before delivery
What Happens When Labor Is Induced?

Read about the process of inducing labor, and what would make it necessary
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Postpartum Care: What Happens After Delivery?
Youve been concentrating on a healthy pregnancy and delivery. Be mindful of the care you'll need after birth
I Want to Read About Possible Complications
What You Should Know About Gestational Diabetes

Only about 18 percent of expecting mothers develop gestational diabetes. Manage and treat this condition
What Is Preeclampsia?
Preeclampsia is a unique form of hypertension that occurs only during pregnancy. Learn what happens in your
body
Teratogen Exposure
Teratogens are agents that can harm a developing fetus. Find out how to protect yourself
Eclampsia: Second Pregnancy Risks

Eclampsia develops in about one out of every 2,000 pregnancies. Understand how your risk changes in your
second pregnancy
Pain, Bleeding, & Discharge: When Should You Worry?

Some types of bleeding, pain, and vaginal discharge are OK. Others aren't. Know when you need to see a doctor
I Want to Stay Active During My Pregnancy
Who Shouldn't Exercise in Pregnancy

It isn't safe for all women to exercise during pregnancy. Discover when exercise isn't safe
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Endurance Exercises in Pregnancy
Endurance exercises increase your heart rate and breathing. Keep your endurance up during pregnancy
Weightlifting in Pregnancy
Weight or strength training improves muscle strength. Learn how to weighlift safely
Exercising During Pregnancy

Choosing to exercise during pregnancy is one of your best decisions. Read about how pregnancy will change your
exercise routine
How to Manage Back Spasms During Pregnancy

One of the most common complaints during pregnancy is back pain and, specifically, back spasms. Get relief from
your back pain
Heal Diastasis Recti: Exercises for New Moms

Diastasis recti is a separation of the abdominals. Find out how to heal it
Target Heart Rate in Pregnancy

Your fitness goals will change during pregnancy. Reach your target heart rate every time you exercise
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Healthy Diet During Pregnancy
Overview
A healthy diet and good nutrition during pregnancy ensure that your baby gets the best start possible. The best diet is a
balanced diet that provides ample amounts of:
protein
carbohydrates
healthy types of fat
vitamins and minerals
Taking prenatal multivitamin will ensure that you get the basic requirements. But vitamin-packed, fresh foods will help
your baby get the best start in life.
What constitutes a healthy diet during pregnancy?
A healthy diet during pregnancy contains much of the same balance of vitamins, minerals, and nutrients as a healthy
diet in general. The difference is that you need higher amounts. If you already have healthy eating habits, it will be easy
to make slight adjustments to ensure a healthy pregnancy.
Calories
The American Pregnancy Association recommends that pregnant women consume an additional 300 calories over their
normal intake requirements. Avoid dieting and the urge to binge eat during pregnancy. The old adage that you need to
eat for two is purely a myth: the key is moderation.
Complex carbohydrates
Whenever possible, eat complex carbohydrates, such as:
whole-grain breads and pastas

vegetables
beans
legumes
Stay away from their nutritionally deficient cousins, the simple carbohydrates:
white bread
cookies
pretzels
chips
sugar
sweeteners
Protein
Eat four servings of protein daily. The American Pregnancy Associationrecommends between 75 and 100 grams daily.
Your doctor may recommend more protein if your pregnancy is considered high risk.
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Vegetables
Eat three or more daily servings of green and yellow vegetables, which contain significant amounts of:
vitamin A
beta-carotene
fiber
vitamin E
riboflavin
folic acid
vitamin B6
calcium
trace minerals
Four additional servings per day should come from fruits and non-green or -yellow vegetables. These provide:
fiber
vitamins
potassium
magnesium
Grains and legumes
Whole grains and legumes, such as dried peas and beans, and other healthy carbohydrates like fruit and starchy
vegetables should comprise nine or more servings a day. They provide B vitamins and trace minerals, such as zinc
selenium and magnesium. Grains and legumes are full of nutrients, including the various B vitamins: thiamin (vitamin B-
1), riboflavin (vitamin B-2), folate and niacin. Your growing baby needs these for the development of just about every
part of the body. Folate intake significantly reduces the risk of having a baby with spina bifida. These foods supply
energy for your babys development and help build the placenta and other tissues in your body.
Fiber
Try to eat 20 to 35 grams of fiber a day to help prevent constipation and hemorrhoids. You can get these from whole
grains, veggies, legumes and fruit. Products labeled refined or enriched arent as beneficial to you or your baby.
Iron
You should eat iron-rich foods daily. Since many women dont get enough iron in their diet, iron is an important part of
prenatal supplements. Iron is often poorly absorbed from plant foods, which is why its difficult for many people to reach
the proper requirement. Talk to your doctor if you are prone to iron-deficiency anemia. They may recommend a
supplement.
Fat
Unhealthy high-fat foods include fried foods, saturated fats, and packaged products containing trans fats. You should
limit these foods to less than four daily servings. However, its dangerous to eliminate all fat from your diet. Essential
fatty acids are important, including omega-3-fatty acids. Some examples of healthy fats include:
walnuts
avocado
pumpkin and sunflower seeds
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chia seeds
flaxseed
fatty fish
olive oil
These foods provide the right types of fats for your babys brain development.
Salt
You should eat salty foods in moderation.
Fluids
Fluids are an important part of a healthy diet. You should consume at least 64 ounces, or eight glasses, per day, and
more is better. During pregnancy, you should avoid caffeinated drinks. They increase your heart rate and blood
pressure, and may affect your babys nervous system development.
Water also reduces your chance of constipation and the subsequent hemorrhoids that can develop from straining during
defecation. The increased flow of urine also reduces your risk of developing a urinary tract infection, which can be
dangerous for you and your baby.
What vitamins do I need during pregnancy?
If you choose to take supplements during your pregnancy, make sure you read the labels of every bottle. Its important
to stay within the daily allowance.
Calcium
Calcium is important for strong bones and teeth, as most people know. But its also critical for proper development and
function of the heart and other muscles, as well as for the blood clotting system. The fetus demands a huge supply of
calcium during development. Its thought to have a total body store of 25 grams of calcium at birth, all of which is
received from the mother.
Pregnant women need 1,000 milligrams of calcium daily, according to the American Pregnancy Association. Milk and
dairy products are great sources of calcium, as is calcium-fortified orange juice and bread. Canned fish with bones,
calcium-set tofu, cooked beans, and cooked dark leafy greens also provide calcium. Prenatal supplements usually
contain only 150 to 200 milligrams of calcium. So prenatal vitamins alone cannot provide sufficient calcium to a
pregnant woman.
Chromium
Chromium is important for your babys development. You should get 50 micrograms per day. Foods that contain
significant amounts of chromium include:
whole-wheat bread
peanut butter
asparagus
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spinach
wheat germ
Copper
Copper stimulates the growth of cells and tissues, hair growth, and general metabolism. Its a critical component of the
babys major systems: the heart and circulatory system, the skeleton, and the nervous system. Two to three milligrams
of copper is recommended daily. If you eat a healthy diet and take a multivitamin, you are certain to get enough.
Folic acid
Folic acid is an important vitamin that stimulates red blood cell formation and the production of important chemical
signals in the nervous system. Its also important in the process of making DNA. Perhaps more importantly, folic acid
has been identified as a critical vitamin to prevent neural tube defects in your baby, such as spina bifida.
The American College of Obstetricians and Gynecologists recommends taking 400 micrograms a day before you
conceive, and at least 600 micrograms a day during pregnancy.
Good sources of folic acid include:
cooked green leafy vegetables

wheat germ
chicken liver
lentils and kidney beans
papaya
fortified cereal
avocado
asparagus
Iodine
Iodine is critical for the development and functioning of the thyroid gland and regulation of metabolism. The
recommended dietary allowance (RDA) for pregnant women is 200 micrograms per day. You can get iodine from:
fluoridated drinking water

iodized (table) salt
eggs
milk
brewers yeast
Iron
Iron is a crucial element in many of the bodys processes. Iron supplements are important for most women, as few
women get enough iron through their diet. Often, women who lack iron become anemic. Iron-deficiency anemia is one
of the most common forms of anemia. It can be regulated through iron supplements.
Your best dietary source of iron is red meat, such as beef. You can get non-heme iron (found in vegetables) from lentils,
spinach, black strap molasses, and many kinds of beans. To improve the absorption of plant or non-heme iron, pair the
food with a vitamin-C rich source. For example, add fresh sliced bell peppers or strawberries to your spinach salad.
The American Pregnancy Association recommends a daily intake of 27 milligrams of iron for pregnant women.
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Magnesium
Magnesium is an important element for teeth and bones, regulation of blood-sugar levels, and the proper functioning of
body proteins. Its also important for tissue growth and repair, and may play a role in reducing preterm delivery. The
RDA for magnesium for pregnant women is 300 milligrams. A good diet usually provides enough magnesium, so its not
present in most prenatal vitamins. The best food sources of magnesium are:
seeds such as sunflower and pumpkin

wheat germ
tofu
almonds
yogurt
You can also take Epsom salt baths twice a week to increase your blood magnesium levels.
Pantothenic acid
This vitamin (B-5) is involved in many of the bodys regulatory and metabolic activities. The recommended daily
allowance for the average person is 4 to 7 milligrams. Pantothenic acid is present in:
organ meats
soybeans
mushrooms
collard greens
brewers yeast
Potassium
Potassium is a mineral that affects cellular function, fluid balance, and blood pressure regulation, as well as proper
nerve and muscle function. While theres no recommended daily allowance for nonpregnant adults, most doctors agree
that pregnant women require at least 2,000 milligrams per day. Prenatal vitamins can provide potassium, but potassium
is present at high levels in foods such as:
bananas
avocados
cantaloupes
oranges
watermelons
dark leafy greens
meats
milk
grains
legumes
squashes
Phosphorus
This element is an important part of the development of the muscular, circulatory, and skeletal systems. The
recommended daily allowance for nonpregnant women is 800 milligrams for adult women and 1,200 milligrams for
younger women. Pregnant women should aim to eat about 1,200 milligrams of phosphorus. Sources include milk,
yogurt, beans, seafood, and nuts.
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Riboflavin (B2)
This vitamin is important for fetal development and growth. The RDA for pregnant women is 1.6 milligrams and 1.8
milligrams for nursing women. A prenatal vitamin may be your best consistent source, but B2 can be found in liver, with
smaller amounts present in soybeans, yogurt, and mushrooms.
Thiamine (B1)
Thiamine is important for metabolism and development of the brain, nervous system, and heart. When youre pregnant,
you need increased amounts of many vitamins, including B1. The RDA for pregnant women is about 1.3 milligrams.
Vitamin A
Vitamin A is critical for proper cell growth and the development of the eyes, skin, blood, and immunity and resistance to
infection.
Vitamin B6 (pyridoxine)
Vitamin B6 is important for your bodys metabolism and for the development of the fetal brain and nervous systems.
The RDA for pregnant women is 2.2 milligrams.
Zinc
The RDA of zinc for pregnant women is 20 milligrams per day and 25 milligrams for nursing women. You can buy
prenatal vitamins that contain zinc. Sources include red meat, seeds, nuts, and beans.
Vitamin B-12
Vitamin B-12 is found mainly in meats and dairy products. So it can be a problem for vegans or strict vegetarians. If you
have dietary restrictions, make sure that your vitamin supplement has adequate B-12. Nutritional yeast, fortified with B-
12, is a great staple for vegetarians. It has a salty and savory flavor and tastes similar to Parmesan cheese.
Vitamin C (ascorbic acid)
The body does not stockpile Vitamin C, so you need regular sources to fulfill your daily requirement. The RDA for
pregnant women is 80 milligrams per day. You can reach your goal through daily intake of citrus fruits, adding fresh
lemon or lime juice to your water, and consuming fresh fruits and vegetables like berries, bell peppers, and broccoli.
Vitamin D
Humans produce vitamin D in their skin in response to sunlight. Vitamin D itself is found naturally only in some fish liver
oils. Since exposure to sunlight is variable and this vitamin is so important for pregnant women and growing children, all
milk is now fortified with vitamin D per quart as regulated by the U.S. government. Vitamin D supplements are
especially important if you dont drink milk.
You should always talk to your doctor and dietitian if you are concerned about your diet. They can help you determine if
you are getting enough nutrients.
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Congestive Heart Failure (CHF)
What is congestive heart failure?

Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your
heart muscles. While often referred to simply as heart failure, CHF specifically refers to the stage in
which fluid builds up around the heart and causes it to pump inefficiently.
You have four heart chambers. The upper half of your heart has two atria, and the lower half of your heart
has two ventricles. The ventricles pump blood to your bodys organs and tissues, and the atria receive
blood from your body as it circulates back from the rest of your body.
CHF develops when your ventricles cant pump blood in sufficient volume to the body. Eventually, blood
and other fluids can back up inside your:
lungs
abdomen
liver
lower body
CHF can be life-threatening.
What are the most common types of CHF?

Left-sided CHF is the most common type of CHF. It occurs when your left ventricle doesnt properly pump
blood out to your body. As the condition progresses, fluid can build up in your lungs, which makes
breathing difficult.
There are two kinds of left-sided heart failure:
Systolic heart failure occurs when the left ventricle fails to contract normally. This reduces the level of
force available to push blood into circulation. Without this force, the heart cant pump properly.
Diastolic failure, or diastolic dysfunction, happens when the muscle in the left ventricle becomes stiff.
Because it can no longer relax, the heart cant quite fill with blood between beats.
Right-sided CHF occurs when the right ventricle has difficulty pumping blood to your lungs. Blood backs
up in your blood vessels, which causes fluid retention in your lower extremities, abdomen, and other vital
organs.
Its possible to have left-sided and right-sided CHF at the same time. Usually, the disease starts in the left
side and then travels to the right when left untreated.
Congestive heart failure stages

Stage Main symptoms Outlook
Class I You dont experience any symptoms during CHF at this stage can be managed through
typical physical activity. lifestyle changes, heart medications, and
monitoring.
Class II Youre likely comfortable at rest, but normal CHF at this stage can be managed through
physical activity may cause fatigue, lifestyle changes, heart medications, and
palpitations, and shortness of breath. careful monitoring.
Class III Youre likely comfortable at rest, but theres Treatment can be complicated. Talk with your
a noticeable limitation of physical activity. doctor about what heart failure at this stage
Even mild exercise may cause fatigue, may mean for you.
palpitations, or shortness of breath.
Class IV Youre likely unable to carry on any amount Theres no cure for CHF at this stage, but
of physical activity without symptoms, there are still quality-of-life and palliative care
which are present even at rest. options. Youll want to discuss the potential
benefits and risks of each with your doctor.
What are the causes of CHF, and am I at risk?

CHF may result from other health conditions that directly affect your cardiovascular system. This is why
its important to get annual checkups to lower your risk for heart health problems, including high blood
pressure (hypertension), coronary artery disease, and valve conditions.
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Hypertension
When your blood pressure is higher than normal , it may lead to CHF. Hypertension occurs when your
blood vessels become restricted by cholesterol and fat. This makes it harder for your blood to pass
through them.
Coronary artery disease
Cholesterol and other types of fatty substances can block the coronary arteries, which are the small
arteries that supply blood to the heart. This causes the arteries to become narrow. Narrower coronary
arteries restrict your blood flow and can lead to damage in your arteries.
Valve conditions
Your heart valves regulate blood flow through your heart by opening and closing to let blood in and out of
the chambers. Valves that dont open and close correctly may force your ventricles to work harder to
pump blood. This can be a result of a heart infection or defect.
Other conditions
While heart-related diseases can lead to CHF, there are other seemingly unrelated conditions that may
increase your risk, too. These include diabetes, thyroid disease, and obesity. Severe infections and
allergic reactions may also contribute to CHF.
What are the symptoms of CHF?
In the early stages of CHF, you most likely wont notice any changes in your health. If your condition
progresses, youll experience gradual changes in your body.
Symptoms you may notice Symptoms that indicate your Symptoms that indicate a severe heart
first condition has worsened condition
chest pain that radiates through the

Fatigue irregular heartbeat upper body
swelling in your ankles, a cough that develops from

feet, and legs congested lungs rapid breathing
skin that appears blue, which is due to

weight gain wheezing lack of oxygen in your lungs
increased need to urinate, shortness of breath, which may

especially at night indicate pulmonary edema fainting
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Chest pain that radiates through the upper body can also be a sign of a heart attack. If you experience
this or any of the other symptoms that may point to a severe heart condition, seek immediate medical
attention.
Symptoms of heart failure in children and infants
It can be difficult to recognize heart failure in infants and young children. Symptoms may include:
poor feeding
excessive sweating
difficulty breathing
These symptoms can easily be misunderstood as colic or a respiratory infection. Poor growth and low
blood pressure can also be signs of heart failure in children. In some cases, you may be able to feel a
resting babys rapid heart rate through the chest wall.
How is CHF diagnosed?
After reporting your symptoms to your doctor, they may refer you to a heart specialist, or cardiologist.
Your cardiologist will perform a physical exam. The exam may involve listening to your heart with a
stethoscope to detect abnormal heart rhythms. To confirm an initial diagnosis, your cardiologist might
order certain diagnostic tests to examine your hearts valves, blood vessels, and chambers.
Here are some tests your cardiologist may recommend:
An electrocardiogram (EKG or ECG) records your hearts rhythm . Abnormalities in your hearts rhythm,
such as a rapid heartbeat or irregular rhythm, could suggest that the walls of your hearts chamber are
thicker than normal. That could be a warning sign for a heart attack.
An echocardiogram uses sound waves to record the hearts structure and motion . The test can determine
if you already have poor blood flow, muscle damage, or a heart muscle that doesnt contract normally.
An MRI takes pictures of your heart. W ith both still and moving pictures, this allows your doctor to see if
theres damage to your heart.
Stress tests show how well your heart performs under different levels of stress. Making your heart work
harder makes it easier for your doctor to diagnose problems.
Blood tests can check for abnormal blood cells and infections. Blood tests can also check the level of
BNP, a hormone that rises with heart failure.
Cardiac catheterization can show blockages of the coronary arteries . Your doctor will insert a small tube
into your blood vessel and thread it from your upper thigh (groin area), arm, or wrist. At the same time,
the doctor can take blood samples, use X-rays to view your coronary arteries, and check blood flow and
pressure in your heart chambers.
How is it treated?
You and your doctor may consider different treatments depending on your overall health and how far your
condition has progressed.
Congestive heart failure drugs
There are several medications that can be used to treat CHF, including:
Angiotensin-converting enzyme inhibitors (ACE inhibitors ) open up narrowed blood vessels to improve
blood flow. Vasodilators are another option if you cannot tolerate ACE inhibitors.
You may be prescribed one of the following:
benazepril (Lotensin)
captopril (Capoten)
enalapril (Vasotec)
fosinopril (Monopril)
lisinopril (Zestril )
quinapril (Accupril)
ramipril (Altace)
moexipril (Univasc)
perindopril (Aceon)
trandolapril (Mavik)
ACE inhibitors shouldnt be taken with the following medications, as they may cause an adverse reaction:
Thiazide diuretics can cause an additional decrease in blood pressure.
Potassium-sparing diuretics, such as triamterene (Dyrenium),eplerenone (Inspra), and spironolactone
(Aldactone), can cause potassium build-up in the blood. This may lead to abnormal heart rhythms .
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen ,aspirin , and naproxen , can cause
sodium and water retention. This may reduce the ACE inhibitors effect on your blood pressure.
This is an abbreviated list, so you shouldnt assume that something is safe to take because it isnt listed.
You should always speak with your doctor before taking any new medications.
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Beta-blockers can reduce blood pressure and slow a rapid heart rhythm.
This may be achieved with:
acebutolol (Sectral)
atenolol (Tenormin)
bisoprolol (Zebeta)
carteolol (Cartrol)
esmolol (Brevibloc)
metoprolol (Lopressor)
nadolol (Corgard)
nebivolol (Bystolic)
propranolol (Inderal LA)
blockers shouldnt be taken with the following medications, as they may cause an adverse reaction:
Antiarrhythmic medications, such as amiodarone (Nexterone), can increase cardiovascular effects,
including reduced blood pressure and slowed heart rate.
Antihypertensive medications, such as lisinopril (Zestril),candesartan (Atacand),
and amlodipine (Norvasc), may also increase the likelihood of cardiovascular effects.
Albuterols (AccuNeb) effects of bronchodilation may be amplified by beta-blockers.
Fentora (Fentanyl ) may cause low blood pressure.
Antipsychotics, such as thioridazine (Mellaril), may also cause low blood pressure.
Clonidine (Catapres) may cause high blood pressure.
Some medications may not be listed here. You should always consult your doctor before taking any new
medications.
Diuretics reduce your bodys fluid content . CHF can cause your body to retain more fluid than it should.
Your doctor may recommend:
Thiazide diuretics, which cause blood vessels to widen and help the body remove any extra fluid.
Examples include metolazone (Zaroxolyn), indapamide (Lozol), and hydrochlorothiazide (Microzide).
Loop diuretics, which cause the kidneys to produce more urine. This helps remove excess fluid from your
body. Examples include furosemide (Lasix), ethacrynic acid (Edecrin), and torsemide (Demadex).
Potassium-sparing diuretics, which help get rid of fluids and sodium while still retaining potassium.
Examples includetriamterene (Dyrenium), eplerenone (Inspra), and spironolactone ( Aldactone ).
Diuretics shouldnt be taken with the following medications, as they may cause an adverse reaction:
ACE inhibitors, such as lisinopril (Zestril), benazepril (Lotensin), andcaptopril (Capoten), can cause
decreased blood pressure.
Tricyclics, such as amitriptyline and desipramine (Norpramin), may cause low blood pressure.
Anxiolytics, such as alprazolam (Xanax), chlordiazepoxide (Librium), and diazepam (Valium), may cause
low blood pressure.
Hypnotics, such as zolpidem (Ambien) and triazolam (Halcion), may cause low blood pressure.
Beta-blockers, such as acebutolol (Sectral) and atenolol (Tenormin), may cause low blood pressure.
Calcium channel blockers, such as amlodipine (Norvasc) anddiltiazem (Cardizem), may cause a drop in
blood pressure.
Nitrates, such as nitroglycerin (Nitrostat) and isosorbide-dinitrate (Isordil), may cause low blood pressure.
NSAIDS, such as ibuprofen , aspirin , and naproxen , may cause toxicity of the liver.
This is an abbreviated list containing only the most common drug interactions. You should always talk to
your doctor before taking any new medications.
Surgeries
If medications arent effective on their own, more invasive procedures may be required. Angioplasty, a
procedure to open up blocked arteries, is one option. Your cardiologist may also consider heart valve
repair surgery to help your valves open and close properly.
What can I expect in the long term?
Your condition may improve with medication or surgery. Your outlook depends on how advanced your CHF
is and whether you have other health conditions to treat, such as diabetes or hypertension. The earlier
your condition is diagnosed, the better your outlook will be. See your doctor to determine the best
treatment plan for you.
CHF and genetics
Is congestive heart failure genetic? Can lifestyle changes help prevent it?
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There has been some early research that shows a gene alteration in people who have congestive heart
failure (CHF). However, this does not necessarily mean it is hereditary. Genes can be altered in other
ways that are not inherited from your parents, such as environmental insults. There are diseases that run
in families that lead to CHF, such as heart valve abnormalities, hypertension (high blood pressure), and
coronary artery disease. If these diseases run in your family, you can help avoid CHF by exercising at
least 150 minutes a week, eating healthfully, and lowering stress.
How to prevent congestive heart failure
There are several things you can do to lower your risk of heart failure, or at least delay onset. You can:
Not to smoke: If you do smoke and havent been able to quit, ask your doctor to recommend products and
services that can help. Secondhand smoke is also a health hazard. If you live with a smoker, ask them to
smoke outdoors.
Maintain a well-balanced diet: A heart-healthy diet is rich in vegetables, fruits, and whole grains. Dairy
products should be low fat or fat-free. You also need protein in your diet. Things to avoid include salt
(sodium), added sugars, solid fats, and refined grains.
Exercise: As little as one hour of moderate aerobic exercise per week can improve your heart health.
Walking, bicycling, and swimming are good forms of exercise. If you havent exercised in a while, start
with just 15 minutes a day and work your way up. If you feel unmotivated to work out alone, consider
taking a class or signing up for personal training at a local gym.
Watch your weight: Being too heavy can be hard on your heart. Follow a balanced diet and exercise
regularly. If you arent at a healthy weight, talk to your doctor about how to move forward. You can also
consult with a dietician or nutritionist.
Be careful: Drink alcohol only in moderation and stay away from illegal drugs. When taking prescription
medications, follow instructions carefully and never increase your dose without doctor supervision.
If youre at high risk for heart failure or already have some heart damage, you can still follow these steps.
Be sure to ask your doctor how much physical activity is safe and if you have any other restrictions. If
youre on medication for high blood pressure, heart disease, or diabetes, take them exactly as directed.
See your doctor regularly to monitor your condition and report any new symptoms right away.
What causes hyperventilation?

Hyperventilation is a condition in which you suddenly start to breathe very quickly. Healthy breathing occurs with a healthy
balance between breathing in oxygen and breathing out carbon dioxide. You upset this balance when you hyperventilate by
exhaling
List of possible causes in order from the most common to the least.
1. Respiratory Alkalosis
This condition is considered a medical emergency. Urgent care may be required.
Respiratory alkalosis occurs when carbon dioxide levels drop too low. This causes the pH of the blood to rise and become
too alkaline.
2. Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a serious complication that stems from diabetes. If you don't have enough insulin to help
your body process sugars (glucose), your body will start burning fat to fuel itself. As a result...
Read more
3 .Heart Failure
Heart failure is characterized by the heart's inability to pump an adequate supply of blood. Learn about heart failure
symptoms, causes, types, and treatment.
Read more
Page 37 of 105
4.Anxiety
Learn more about anxiety with this overview of anxiety disorders.

Read more
5.Stress And Anxiety
Stress and anxiety are a normal part of life, but in some people, they can become bigger issues. Learn what causes stress
and anxiety and how to manage them.
Read more
6.Panic Disorder
Panic disorder occurs when you live in fear of a panic attack. You may be having a panic attack when you feel sudden,
overwhelming terror with no obvious cause.
Read more
7.Pulmonary Embolism
A pulmonary embolism is a blood clot that occurs in the lungs. It can damage part of the lung and other organs and
decrease oxygen levels in the blood.
Read more
8.Heat Emergencies
Heat emergencies are health crises caused by exposure to hot weather and sun. Heat emergencies have three stages:
heat cramps, heat exhaustion, and heatstroke.
Read more
9.Pregnancy
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Bleeding or spotting, increased need to urinate, tender breasts, fatigue, nausea, and missed period are signs of pregnancy.
Read more
10.Sepsis
Image attribution
One life-threatening complication of infection is sepsis, which often occurs in people who are elderly or have weak immune
systems. Patches of discolored skin is a symptom of severe sepsis.
Read more
11.Pneumonia
Pneumonia is an infection of the lungs caused by fungi, bacteria, or viruses. General symptoms include chest pain, fever,
cough, and difficulty breathing.
Read more
12.Cystic Fibrosis
Cystic fibrosis causes severe damage to the respiratory and digestive systems. Learn about its symptoms, causes,
diagnosis, and treatment.
Read more
Page 39 of 105
What causes ascites?
18 possible conditions
When fluid builds up inside the abdomen, it is known as ascites. Ascites usually occurs when the liver stops working
properly. Fluid fills the space between the lining of the abdomen and the organs. Read more
See a list of possible causes in order from the most common to the least.
1.Peritonitis
Image attribution
Peritonitis is the inflammation of a thin layer of tissue inside the abdomen. Caused by bacteria or fungus, it causes
tenderness, bloating, fatigue, greying of the skin, and other problems.
Read more
2.Alcoholic Liver Cirrhosis
If you drink heavily for a long time, your body starts to replace the liver's healthy tissue with scar tissue. This is called
alcoholic liver cirrhosis.
Read more
3.Liver Cancer
Learn about liver cancer symptoms, types, diagnosis, treatment, and prevention.
Read more
4.Chronic Pancreatitis
Image attribution
Chronic, or long-term, pancreatitis is an inflammation of your pancreas that impairs your body's ability to digest food and
regulate blood sugar.
Read more
5.Congestive Heart Failure (CHF)
Congestive heart failure (CHF) is a chronic condition that affects the chambers of your heart. Learn more about CHF,
including symptoms and risk factors.
Read more
6.Hepatitis
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Image attribution
Hepatitis refers to an inflammatory condition of the liver. It's commonly caused by a viral infection, but there are other
possible causes of hepatitis.
Read more
7.Cirrhosis
Image attribution
Cirrhosis is the severe scarring and poor function of the liver caused by long-term exposure to toxins such as alcohol or
viral infections.
Read more
8.Pancreatic Cancer
Pancreatic cancer is one of the most deadly forms of cancer and is often difficult to detect. Learn more about symptoms and
treatments.
Read more
9.Hepatic Vein Thrombosis (Budd-Chiari Syndrome)
Hepatic vein thrombosis (HVT) is an obstruction in the veins of the liver caused by a blood clot. This condition blocks blood
flow from the liver to the heart.
Read more
10.Non-Hodgkins Lymphoma
Image attribution
Non-Hodgkin lymphoma (NHL) is a cancer of the lymphatic system that occurs when tumors develop from the lymphocytes,
which are a type of white blood cell.
Read more
11.Ovarian Cancer
Image attribution
The ovaries are small organs on either side of the uterus. They're where eggs are produced. Ovarian cancer can occur in
different parts of the ovary.
Read more
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12.Pericarditis
Pericarditis is the inflammation of the sac that surrounds your heart. The sac is a double-layered membrane called the
pericardium. The pericardium protects your heart and helps it function properly.Pericarditis can b...
Read more
13.Burkitt's Lymphoma
Image attribution
Burkitt's lymphoma is a relatively rare and aggressive form of non-Hodgkin lymphoma.
Read more
14.Hepatitis B
Image attribution
Hepatitis B is liver inflammation caused by the hepatitis B virus (HBV).
Read more
15.Hepatitis C
Image attribution
Hepatitis C is a disease that causes inflammation and infection of the liver. Read more about this disease that affects
millions of people worldwide.
Read more
16.Alcoholic Liver Disease
Damage to the liver from excessive drinking can lead to ALD. Years of alcohol abuse cause the liver to become inflamed
and swollen. This damage can also cause scarring known as cirrhosis. Cirrhosis is the final stage o...
Read more
17.Hepatitis E
Image attribution
The hepatitis E virus is spread most often by contaminated drinking water. It is different from the hep-A virus but the
symptoms are similar. Most cases clear up on their own after a few weeks. In other cases, the viru...
Read more
18.Hepatitis D
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Hepatitis D is an infection that causes the liver to become inflamed. Learn about hepatitis D symptoms, risk factors,
Read more
Page 43 of 105
Obesity
What Is Obesity?
Obesity is an epidemic in the U.S. This condition puts people at a higher risk for serious diseases, such as type 2 diabetes,
heart disease, and cancer. According to the Centers for Disease Control and Prevention (CDC), it is estimated that more
than one-third of American adults (34.9 percent) and 17 percent (12.7 million) of American children and teens are clinically
obese.
Obesity is defined as having a body mass index (BMI) of 30 or more. BMI is a calculation that takes a persons weight and
height into account. However, BMI does have some limitations. According to the CDC, Factors such as age, sex, ethnicity,
and muscle mass can influence the relationship between BMI and body fat. Also, BMI does not distinguish between excess
fat, muscle, or bone mass, nor does it provide any indication of the distribution of fat among individuals. Despite these
limitations, BMI continues to be widely used as an indicator of excess weight.
What Causes Obesity?

Eating more calories than you burn in daily activity and exercise (on a long-term basis) causes obesity. Over time, these
extra calories add up, and cause you to gain weight.
Common specific causes of obesity include:
eating a poor diet of foods high in fats and calories
having a sedentary (inactive) lifestyle
not sleeping enough, which can lead to hormonal changes that make you feel more hungry and crave certain high-
calorie foods
genetics, which can affect how your body processes food into energy and how fat is stored
growing older, which can lead to less muscle mass and a slower metabolic rate, making it easier to gain weight
pregnancy (weight gained during pregnancy can be difficult to lose and may eventually lead to obesity)
Certain medical conditions may also lead to weight gain. These include:
polycystic ovary syndrome (PCOS): a condition that causes an imbalance of female reproductive hormones
Prader-Willi syndrome: a rare condition that an individual is born with which causes excessive hunger
Cushings syndrome: a condition caused by having an excessive amount of the hormone cortisol in your system
hypothyroidism (underactive thyroid): a condition in which the thyroid gland does not produce enough of certain
important hormones
osteoarthritis (and other conditions that cause pain that may lead to inactivity)
Who Is at Risk for Obesity?

A complex mix of genetic, environmental, and psychological factors can increase a persons risk for obesity.
Genetics
Some people possess genetic factors that make it difficult for them to lose weight.
Environment and Community
Your environment at home, at school, and in your community can all influence how and what you eat and how active you
are. Maybe you have not learned to cook healthy meals, or do not think you can afford healthier foods. If your neighborhood
is unsafe, maybe you have not found a good place to play, walk, or run.
Psychological and Other Factors
Depression can sometimes lead to weight gain, as an individual turns to food for emotional comfort.
Quitting smoking is a good thing, but quitting can also lead to weight gain, so it is important to focus on diet and exercise
while you are quitting.
Medications such as steroids and certain antidepressants or birth control pills can also put you at greater risk for weight
gain.
How Is Obesity Diagnosed?

Obesity is defined as having a BMI of 30 or more. Body mass index is a rough calculation of a persons weight in relation to
their height.
Other more accurate measures of body fat and body fat distribution include skinfold thickness, waist-to-hip comparisons,
and screening tests such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) scans.
Your doctor may also order certain tests to help diagnose obesity as well as obesity-related health risks. These may include
blood tests to examine cholesterol and glucose levels, liver function tests, diabetes screen, thyroid tests, and heart tests,
such as an electrocardiogram. A measurement of the fat around your waist is also a good predictor of risk for obesity-
related diseases.
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What Are Complications of Obesity?
Obesity leads to much more than simple weight gain. Having a high ratio of body fat to muscle puts strain on your bones as
well as your internal organs. It also increases inflammation in the body, which is thought to be a cause of cancer. Obesity is
also a major cause of type 2 diabetes.
Obesity has been linked to a number of health complications, some of which are life-threatening:
type 2 diabetes
heart disease
high blood pressure
certain cancers (breast, colon, and endometrial)
stroke
gallbladder disease
fatty liver disease
high cholesterol
sleep apnea and other breathing problems
arthritis
infertility
How Is Obesity Treated?

If you are obese and have not been able to lose weight on your own, medical help is available. Start with your family
physician, they may be able to refer you to a weight specialist in your area. Your doctor may also want to work with you as a
team to help you lose weight, along with a dietitian, therapist, and other healthcare staff.
Your doctor will work with you on making lifestyle changes. Sometimes, they may recommend medications or weight loss
surgery as well.
Lifestyle and Behavior Changes
Your healthcare team can educate you on better food choices and help develop a healthy eating plan that works for you. A
structured exercise program and increased daily activity up to 300 minutes a week will help build up your strength,
endurance, and metabolism. Counseling or support groups may also identify unhealthy triggers and help you cope with any
anxiety, depression, or emotional eating issues.
Medical Weight Loss
Your doctor may also prescribe certain prescription weight loss medications in addition to healthy eating and exercise plans.
Medications are usually prescribed only if other methods of weight loss have not worked, and if you have a BMI of 27 or
more in addition to obesity-related health issues.
Prescription weight loss medications either prevent the absorption of fat or suppress appetite. These drugs can have
unpleasant side effects. For example, the drug orlistat (Xenical) can lead to oily and frequent bowel movements, bowel
urgency, and gas. Your doctor will monitor you closely while you are taking these medications.
Weight Loss Surgery
Weight loss surgery, commonly called bariatric surgery, requires a commitment from patients that they will change their
lifestyle. These types of surgery work by limiting how much food you can comfortably eat or by preventing your body from
absorbing food and calories. Sometimes they do both.
Weight loss surgery is not a quick fix. It is a major surgery and can have serious risks. After surgery, patients will need to
change how they eat and how much they eat or risk getting sick.
Candidates for weight loss surgery will have a BMI of 40 or more, or have a BMI of 35 to 39.9 along with serious obesity-
related health problems.
Patients will often have to lose weight prior to undergoing surgery. Additionally, they will normally undergo counseling to
ensure that they are both emotionally prepared for this surgery and willing to make the necessary lifestyle changes that it
will require.
Surgical options include:
gastric bypass surgery, which creates a small pouch at the top of your stomach that connects directly to your small
intestine. Food and liquids go through the pouch and into the intestine, bypassing most of the stomach.
laparoscopic adjustable gastric banding (LAGB), which separates your stomach into two pouches using a band
gastric sleeve, which removes part of your stomach
biliopancreatic diversion with duodenal switch, which removes most of your stomach
What Is the Long-Term Outlook for Obesity?
There has been a dramatic increase in obesity in the U.S. over the past 20 years, as well as obesity-related diseases. This
is the reason why communities, states, and the federal government are putting an emphasis on healthy food choices and
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activities to help turn the tide on obesity. Ultimately, however, the responsibility is on each of us to make these healthy
changes.
How Can You Prevent Obesity?

Help prevent weight gain by making good lifestyle choices. Aim for moderate exercise (walking, swimming, biking) for 20 to
30 minutes every day.
Eat well by choosing nutritious foods like fruits, vegetables, whole grains, and lean protein. Eat high-fat, high-calorie foods
in moderation.
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Generalized Anxiety Disorder
What Is Generalized Anxiety Disorder?

People who suffer from generalized anxiety disorder, or GAD, worry uncontrollably about common occurrences and
situations. Its also sometimes known as chronic anxiety neurosis.
GAD is different than normal feelings of anxiousness. Its common to feel anxious about the things happening in your life
like your finances every once in awhile. A person who has GAD may worry uncontrollably about their finances several
times a day for months on end. This can happen even when there isnt a reason to worry. The person is often aware that
there is no reason for them to worry. Sometimes people with this condition just worry, but they are unable to say what they
are worried about. They report feelings that something bad may happen or may report that they just cant calm themselves.
This excessive, unrealistic worry can be frightening and can interfere with relationships and daily activities.
Symptoms of Generalized Anxiety Disorder

Symptoms of GAD include:
difficulty concentrating
difficulty sleeping
irritability
fatigue/exhaustion
muscle tension
repeated stomachaches or diarrhea
sweating palms
shaking
rapid heartbeat
neurological symptoms such as complaints of numbness/tingling of different parts of the body
Distinguishing GAD from Other Mental Health Issues
Anxiety is a common symptom of many mental health conditions, like depression and various phobias. GAD is different
from these conditions in several ways.
People experiencing depression may occasionally feel anxious. People suffering from phobias worry about one particular
thing, but people suffering from GAD worry about a number of different topics over a long period of time (six months or
more), or may not be able to identify the source of their worry.
What Are the Causes and Risk Factors of GAD?

Causes of and risk factors for GAD may include:
a family history of anxiety
recent or prolonged exposure to stressful situations, including personal or family illnesses
excessive use of caffeine or tobacco (which can make existing anxiety worse)
being the victim of childhood abuse
According to the Mayo Clinic, women are twice as likely to experience GAD than men.
How Is Generalized Anxiety Disorder Diagnosed?

GAD is diagnosed with a mental health screening that your primary care provider can perform. They will ask you questions
about your symptoms and how long youve been experiencing them. They can refer you to a mental health specialist, such
as a psychologist or psychiatrist.
Medical tests may also be used to determine whether there is an underlying illness or substance abuse problem causing
your symptoms. Anxiety has been linked to gastroesophageal reflux disease (GERD), thyroid disorders, heart disease, and
menopause.
If your primary care provider suspects that a medical condition or substance abuse problem is the cause of the anxiety, they
may perform more tests. These may include:
blood tests to check hormone levels (thyroid disorders)
urine tests to check for substance abuse
gastric reflux tests (X-ray of your digestive system, endoscopy procedure to look at your esophagus) to check for
GERD
X-rays and stress tests (monitoring your heart function while you exercise) to check for heart conditions
How Is Generalized Anxiety Disorder Treated?
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Cognitive Behavioral Therapy
This involves meeting regularly to talk with a mental health professional. The goal is to change your thinking and behaviors.
This approach has been successful in achieving permanent change in many people who suffer from anxiety, and is
considered first-line treatment of anxiety disorders in persons who are pregnant. Others have found that the benefits of
cognitive behavioral therapy have provided long-term relief from anxiety.
In therapy sessions, you will learn how to recognize and control your anxious thoughts. Your therapist will also teach you
how to calm yourself when upsetting thoughts arise.
Doctors often prescribe medicines along with therapy to treat GAD.
Drugs and Medication
Your prescriber will most likely create a short-term medication plan and a long-term medication plan.
Short-term medications relax some of the physical symptoms of anxiety, such as muscle tension and stomach cramping.
These are called anti-anxiety medicines. Some common anti-anxiety medications are:
alprazolam (Xanax)
clonazepam (Klonopin)
lorazepam (Ativan)
buspirone (Buspar)
Anti-anxiety medicines arent meant to be taken for long periods of time, as they have a high risk for dependence and
abuse.
Medicines called antidepressants work well for long-term treatment. Some common antidepressants are:
citalopram (Celexa)
escitalopram (Lexapro)
fluoxetine (Prozac, Prozac Weekly, Sarafem)
fluvoxamine (Luvox, Luvox CR)
paroxetine (Paxil, Paxil CR, Pexeva)
sertraline (Zoloft)
venlafaxine (Effexor XR)
desvenlafaxine (Pristiq)
duloxetine (Cymbalta)
These medicines can take a few weeks to start working. They can also have side effects, such as dry mouth, nausea, and
diarrhea. These symptoms bother some people so much that they stop taking these medications.
There is a very low risk of young adults experiencing an increase in suicidal thoughts at the beginning of treatment with
antidepressants. Stay in close contact with your prescriber if youre taking antidepressants. Make sure you report any mood
or thought changes that worry you.
Your doctor may prescribe both an anti-anxiety medication and an antidepressant. If so, youll probably only take the anti-
anxiety medicine for a few weeks until your antidepressant starts working, or on an as-needed basis.
Lifestyle Changes to Help Ease Symptoms of GAD

Many people can find relief by adopting certain lifestyle habits. These may include:
regular exercise, a healthy diet, and plenty of sleep
yoga and meditation
avoiding stimulants, such as caffeine, and some over-the-counter medicines such as diet pills or caffeine pills
talking with a trusted friend, spouse, or family member about fears and worries
Alcohol and Anxiety
Drinking alcohol can make you feel less anxious almost immediately. This is why many people who suffer from anxiety turn
to drinking alcohol to feel better.
However, its important to remember that alcohol can have a negative effect on your mood. Within a few hours or the day
after drinking, you may experience more irritability or depression. It can also interfere with the medications used to treat the
condition. Some medication and alcohol combinations can be fatal.
If you find that your drinking is interfering with your daily activities, talk to your primary care provider. You can also find free
support to stop drinking through Alcoholics Anonymous (AA).
Outlook for Those with Generalized Anxiety Disorder

Most people can manage GAD with a combination of therapy, medicine, and lifestyle changes. Talk to your doctor if youre
concerned about how much you worry. They can refer you to a mental health specialist.
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What causes lactose intolerance?
Lactose intolerance is the inability to break down a type of natural sugar called lactose. Lactose is commonly found in dairy
products, such as milk and yogurt. A person becomes lactose intolerant when his or her small intestine stops making
enough of the... Read more
1.The Many Sides of Bacterial Gastroenteritis
Bacterial infections are common causes of gastrointestinal infections. This type of infection is also called "food poisoning"
and is often caused by poor hygiene or ingesting foods contaminated with bacteria.
Read more
2.Crohns Disease
Crohn's disease is a chronic bowel disease that causes severe inflammation of the digestive tract. It is associated with
abdominal pain, diarrhea, and may affect your quality of life. Crohn's disease is characterized b...
Read more
3.Celiac Disease (Gluten Intolerance)
Celiac disease is a digestive disorder caused by an abnormal immune reaction to gluten. Learn about celiac disease
systems, diagnosis, and treatment.
Read more
4.Cystic Fibrosis
Cystic fibrosis causes severe damage to the respiratory and digestive systems. Learn about its symptoms, causes,
Read more
Page 49 of 105
What Do You Want to Know About IBS?
A syndrome is a collection of symptoms that often occur together. Irritable bowel syndrome (IBS) is a common syndrome
that causes many individuals to seek medical help. This condition is separate from inflammatory bowel disease and is not
related to other bowel conditions.
I Want a General Understanding of IBS
How Many Types of IBS Are There?

Learn how doctors categorize the subtypes of irritable bowel syndrome and what they mean for treatment
IBS Differences in Men and Women

Many symptoms can happen in anyone, but women and men might also experience IBS differently. Find out how
Is It IBS or Something Else?

Identify the symptoms that do and don't occur in IBS and read about similar conditions
IBS Causes and Risk Factors

See the list of common IBS causes, including nervous system and bacterial problems, and assess your risk
From Brain to Bowels: Serotonin and IBS

Did you know you have a nervous system in your gut? Discover how neurotransmitters like serotonin can affect
your digestion
Newly Diagnosed with IBS? Questions to Ask Your Doctor

Take these questions to your appointment and start your treatment on the right foot
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7 Tips for Avoiding IBS Flare-Ups
Find long-term solutions by making these changes in managing your diet, nutrition, lifestyle, and stress
I Want to Manage My IBS Symptoms
Diagnosing IBS
Understand how doctors diagnose IBS and know what to expect from the process
IBS Home Remedies That Work

From keeping active to kicking back, personalize your prevention with six easy, everyday tips
Tailor Your IBS Treatment

Read the IBS treatment guide and know all of your options for suppressing symptoms
Bid Goodbye to Bloating

Learn about five methods for managing this common IBS symptom and medication side effect
Is IBS to Blame for Your Back Pain?

What does back pain have to do with IBS? Get answers and see what you can do about it
Find Relief for Constipation

Don't deal with this frustrating and uncomfortable symptom. Find relief and get back to your regular self
Page 51 of 105
Managing IBS Gas
IBS can lead to gas, and some treatments might even make it worse. Consider these methods for doing away with
uncomfortable gas
Tips for Nausea Relief

Examine the possible causes of a queasy stomach and know how to reduce discomfort
I Want Diet and Lifestyle Tips
7 Diets for IBS

Explore the most common diets that reduce embarrassing symptoms and work towards leading a normal life
Identify Your IBS Trigger Foods

IBS can affect people differently. Find out what it means for you by recognizing and tracking your trigger foods
The Importance of Weight Management

Weight loss and gain are no strangers to IBS. Understand the possibilities and take control today
IBS and Your Pregnancy

Whether you already have IBS or are newly diagnosed during pregnancy, learn to control symptoms now and after
your baby is born
Types of IBS
Overview
Highlights
IBS is a common disorder affecting your large intestine and causing abdominal pain, constipation, or diarrhea.
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There are four subtypes of IBS based on the consistency of your stools.
There is no cure for IBS. However, treatment is aimed at managing symptoms so you can lead a healthy life.
Everyone experiences some level of bowel discomfort during their lives, but irritable bowel syndrome (IBS) is different. IBS
affects your large intestine. Symptoms vary, but the most common include:
abdominal pain
cramping
bloating
gas
diarrhea
constipation
These symptoms can come and go in waves. Flare-ups can occur frequently and last for hours, days, weeks, or even
months. Although IBS is not life-threatening, it can certainly affect your quality of life by disrupting your work and social life.
Symptoms of IBS can vary from person to person. There are also four subtypes of IBS that are categorized based on the
consistency of your stools. Proper diagnosis of the subtype of IBS you have is important so you can get the most effective
treatment.
Tests and diagnosis

Your doctor will likely start the diagnosis process by asking what kind of symptoms youve been having and how often
youve been experiencing them. Your doctor will also probably ask you about your medical history, stressors in your life, and
medications you are taking.
Your doctor may also perform some tests that could include:
flexible sigmoidoscopy: an examination of the lower part of your colon, or sigmoid
colonoscopy: an examination of your colon
X-rays of your colon
CT scan of your abdomen and pelvis
lower GI series: an examination where the large intestine is filled with liquid barium and then an X-ray is taken to see
different abdominal structures
blood tests
stool tests
Types of IBS
The Rome Foundation is an organization that researches, defines, and classifies functional gastrointestinal disorders such
as IBS.
Doctors have defined four subtypes of IBS. Each subtype is defined by stool consistency during a flare-up.
Knowing the subtype of IBS you have will help your doctor pinpoint possible triggers and prescribe the appropriate
treatment for you.
IBS with constipation (IBS-C)
This category of IBS causes hard, possibly painful stools more than 25 percent of the time. People with this subtype may
also experience diarrhea or watery stools less than 25 percent of the time.
Your doctor may want to perform imaging tests to rule out anatomical abnormalities. You may also be encouraged to add
more fiber to your diet either by eating more whole grains or taking a daily supplement. Additional fiber can help soften your
stools, making them easier to pass.
IBS with diarrhea (IBS-D)

People with this subtype of IBS experience diarrhea, or loose, watery stools more than 25 percent of the time. Typically they
dont experience constipation or have difficulty passing stools.
To overcome diarrhea, your doctor may recommend eating smaller, more frequent meals. Food sensitivities may also be
considered, so dietary modifications could be suggested. Limiting dairy products, spicy foods, and foods containing artificial
sweeteners may cause loose stools.
Mixed type (IBS-M)

Some people with IBS dont have subtype IBS-C or IBS-D. People with IBS that falls into this category experience
constipation and diarrhea equally, both more than 25 percent of the time.
If this is the case, its important to identify triggers and find a balance of treatments so one symptom doesnt cause the
other.
In addition to identifying possible food sensitivities there are also other steps to take:
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make necessary dietary changes
avoid stressful situations
get a prescription for anti-diarrheal medication and laxatives
Unsubtyped IBS
This subtype includes IBS symptoms such as:
cramping
abdominal discomfort
bloating
gas
passing mucus
However, people with this subtype dont usually experience stool irregularities. Treatment requires identifying triggers and
treating individual symptoms.
Part 4 of 4
Outlook
IBS can be a painful disorder and currently doesnt have a cure. Its important to seek medical attention right away if you
have bleeding from the rectum, weight loss, or worsening nighttime abdominal pain.
Understanding IBS and the subtype you have will help you and your doctor find an effective treatment plan and manage
your symptoms.
Read This Next
IBS-M: Causes, Symptoms, and Treatment
Read More
IBS-D: Diagnosis and Treatment Options
Read More
IBS-C: An Overview
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Read More
What Causes IBS-C? The Brain-Gut Connection
Read More
Managing the Symptoms of IBS-D
Read More
IBS - Personalize Your Prevention
The symptoms of irritable bowel syndrome (IBS) are uncomfortable and can be embarrassing too. Cramping, bloating, gas,
and diarrhea are never fun. Yet there are several lifestyle changes and home remedies that you can try to provide some
relief. Although everyones body is different, once you find remedies that work, you can try them to prevent discomfort.
Work Out
Exercise is tried and true for many to relieve stress, depression, and anxiety especially when it is done consistently.
Anything that relieves stress can help with bowel discomfort by stimulating regular intestinal contractions. If youre not used
to exercising, be sure to start slow and work your way up to the American Heart Association-recommended amount of 30
minutes a day, five days a week.
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Relax
Exercise is tried and true for many to relieve stress, depression, and anxiety especially when it is done consistently.
Anything that relieves stress can help with bowel discomfort by stimulating regular intestinal contractions. If youre not used
to exercising, be sure to start slow and work your way up to the American Heart Association-recommended amount of 30
minutes a day, five days a week.
Eat More Fiber
Fiber is a bit of a mixed bag for IBS sufferers. It helps ease some symptoms, including constipation, but can actually worsen
other symptoms like cramping and gas. Still, high-fiber foods such as fruits, vegetables, and beans are recommended as an
IBS treatment if taken gradually over several weeks. In some cases, your doctor may recommend that you take a fiber
supplement, such as Metamucil, rather than dietary fiber. According to the recommendations from the American College of
Gastroenterology, food that contains psyllium (a type of fiber) may help more with the symptoms of IBS than food that
contains bran.
Go Easy on the Dairy
Some people who are lactose intolerant have IBS. In this case, you can try eating yogurt instead of milk for your dairy
requirements or consider using an enzyme product to help you process lactose. Your doctor may recommend avoiding
dairy products entirely, in which case youll need to ensure that you consume enough protein and calcium from other
sources. Talk to a dietitian if you have questions about how to do this.
Be Cautious With Laxatives
Your over-the-counter (OTC) choices can improve your IBS symptoms or make them worse, depending on how you use
them. The Mayo Clinicrecommends using caution if you use OTC anti-diarrheal medicines, such as Kaopectate or Imodium,
or laxatives, such as polyethylene glycol or milk of magnesia. Some medicines need to be taken 20 to 30 minutes before
you eat to help prevent symptoms. Follow the directions on the package to avoid problems.
Make Smart Food Choices
It goes without saying that certain foods can make gastrointestinal (GI) pain worse. Be on the lookout for which foods
exacerbate your symptoms, and be sure to avoid them. Some common problem foods and drinks include:
beans
cabbage
cauliflower
broccoli
alcohol
chocolate
coffee
soda
dairy products
While there are some foods that you should avoid, there are also some foods you can eat that can help IBS.
The ACG suggests that foods containing probiotics, or bacteria or yeast that is helpful to your digestive system, have
helped relieve some symptoms of IBS, such as bloating and gas.
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Do Your Part
IBS can be a pain in the stomach, but you can take steps to prevent or alleviate symptoms. Managing your stress and
watching your diet are two of the best ways to relieve IBS symptoms from home. Talk to your healthcare provider if youre
uncertain about which lifestyle techniques to try or the best way to start them.
Definition & Facts for Irritable Bowel Syndrome
What is IBS?
Irritable bowel syndrome (IBS) is a group of symptomsincluding pain or discomfort in your abdomenand changes in
your bowel movement patternsthat occur together. Doctors call IBS a functional gastrointestinal (GI) disorder. Functional
GI disorders happen when your GI tract behaves in an abnormal way without evidence of damage due to a disease.
Does IBS have another name?
In the past, doctors called IBS colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel. Experts changed the
name to reflect the understanding that the disorder has both physical and mental causes and isnt a product of a persons
imagination.
What are the four types of IBS?
Doctors often classify IBS into one of four types based on your usual stool consistency. These types are important because
they affect the types of treatment that are most likely to improve your symptoms.
The four types of IBS are
IBS with constipation, or IBS-C

hard or lumpy stools at least 25 percent of the time
loose or watery stools less than 25 percent of the time
IBS with diarrhea, or IBS-D
loose or watery stools at least 25 percent of the time
hard or lumpy stools less than 25 percent of the time
Mixed IBS, or IBS-M
hard or lumpy stools at least 25 percent of the time
loose or watery stools at least 25 percent of the time
Unsubtyped IBS, or IBS-U
hard or lumpy stools less than 25 percent of the time
loose or watery stools less than 25 percent of the time
How common is IBS?
Studies estimate that IBS affects 10 to 15 percent of U.S. adults. 1 However, only 5 to 7 percent of U.S. adults have received
a diagnosis of IBS.2
Who is more likely to develop IBS?
IBS affects about twice as many women as men and most often occurs in people younger than age 45. 1
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What other health problems do people with IBS have?
People with IBS often suffer from other GI and non-GI conditions. GI conditions such as gastroesophageal reflux
disease and dyspepsia are more common in people with IBS than the general population.
Non-GI conditions that people with IBS often have include
chronic fatigue syndrome

chronic pelvic pain
temporomandibular joint disorders
depression
anxiety
somatoform disorders
Symptoms & Causes of Irritable Bowel Syndrome
What are the symptoms of IBS?
The most common symptoms of irritable bowel syndrome (IBS) include pain or discomfort in yourabdomen and changes in
how often you have bowel movements or how your stools look. The pain or discomfort of IBS may feel like cramping and
have at least two of the following:
Your pain or discomfort improves after a bowel movement.

You notice a change in how often you have a bowel movement.
You notice a change in the way your stools look.
IBS is a chronic disorder, meaning it lasts a long time, often years. However, the symptoms may come and go. You may
have IBS if:
Youve had symptoms at least three times a month for the past 3 months.
Your symptoms first started at least 6 months ago.
People with IBS may have diarrhea, constipation, or both. Some people with IBS have only diarrhea or only constipation.
Some people have symptoms of both or have diarrhea sometimes and constipation other times. People often have
symptoms soon after eating a meal.
Other symptoms of IBS are
bloating
the feeling that you havent finished a bowel movement
whitish mucus in your stool
Women with IBS often have more symptoms during their menstrual periods.
While IBS can be painful, IBS doesnt lead to other health problems or damage your gastrointestinal (GI) tract.
What causes IBS?
Doctors arent sure what causes IBS. Experts think that a combination of problems can lead to IBS.
Physical Problems
Brain-Gut Signal Problems
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Signals between your brain and the nerves of your gut, or small and large intestines, control how your gut works. Problems
with brain-gut signals may cause IBS symptoms.
GI Motility Problems
If you have IBS, you may not have normal motility in your colon. Slow motility can lead to constipation and fast motility can
lead to diarrhea. Spasms can cause abdominal pain. If you have IBS, you may also experience hyperreactivitya dramatic
increase in bowel contractions when you feel stress or after you eat.
Pain Sensitivity
If you have IBS, the nerves in your gut may be extra sensitive, causing you to feel more pain or discomfort than normal
when gas or stool is in your gut. Your brain may process pain signals from your bowel differently if you have IBS.
Infections
A bacterial infection in the GI tract may cause some people to develop IBS. Researchers dont know why infections in the
GI tract lead to IBS in some people and not others, although abnormalities of the GI tract lining and mental health problems
may play a role.
Small Intestinal Bacterial Overgrowth
Normally, few bacteria live in your small intestine. Small intestinal bacterial overgrowth is an increase in the number or a
change in the type of bacteria in your small intestine. These bacteria can produce extra gas and may also cause diarrhea
and weight loss. Some experts think small intestinal bacterial overgrowth may lead to IBS. Research continues to explore a
possible link between the two conditions.
Neurotransmitters (Body Chemicals)
People with IBS have altered levels of neurotransmitterschemicals in the body that transmit nerve signalsand GI
hormones. The role these chemicals play in IBS is unclear.
Younger women with IBS often have more symptoms during their menstrual periods. Post-menopausal women have fewer
symptoms compared with women who are still menstruating. These findings suggest that reproductive hormones can
worsen IBS problems.
Genetics
Whether IBS has a genetic cause, meaning it runs in families, is unclear. Studies have shown IBS is more common in
people with family members who have a history of GI problems.
Food Sensitivity
Many people with IBS report that foods rich in carbohydrates, spicy or fatty foods, coffee, and alcohol trigger their
symptoms. However, people with food sensitivity typically dont have signs of a food allergy. Researchers think that poor
absorption of sugars or bile acids may cause symptoms.
Mental Health Problems
Psychological, or mental health, problems such as panic disorder , anxiety , depression , and post-traumatic stress
disorder are common in people with IBS. The link between mental health and IBS is unclear. GI disorders, including IBS,
are sometimes present in people who have reported past physical or sexual abuse. Experts think people who have been
abused tend to express psychological stress through physical symptoms.
If you have IBS, your colon may respond too much to even slight conflict or stress. Stress makes your mind more aware of
the sensations in your colon. IBS symptoms can also increase your stress level.
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Treatment for Irritable Bowel Syndrome
How do doctors treat IBS?
Though irritable bowel syndrome (IBS) doesnt have a cure, your doctor can manage the symptoms with a combination of
diet, medicines, probiotics, and therapies for mental health problems. You may have to try a few treatments to see what
works best for you. Your doctor can help you find the right treatment plan.
Changes in eating, diet, and nutrition
Changes in eating, diet, and nutrition, such as following a FODMAP diet, can help treat your symptoms.
Medicines
Your doctor may recommend medicine to relieve your symptoms.
Fiber supplements to relieve constipation when increasing fiber in your diet doesnt help.
Laxatives to help with constipation. Laxatives work in different ways, and your doctor can recommend a laxative
thats right for you.
Loperamide to reduce diarrhea by slowing the movement of stool through your colon. Loperamide is
an antidiarrheal that reduces diarrhea in people with IBS, though it doesnt reduce pain,bloating, or other symptoms.
Antispasmodics, such as hyoscine, cimetropium, and pinaverium, help to control colon muscle spasmsand reduce
pain in your abdomen.
Antidepressants , such as low doses of tricyclic antidepressants and selective serotonin reuptake inhibitors, to
relieve IBS symptoms, including abdominal pain. In theory, because of their effect on colon transit, tricyclic antidepressants
should be better for people with IBS with diarrhea, or IBS-D, and selective serotonin reuptake inhibitors should be better for
people with IBS with constipation, or IBS-C, although studies havent confirmed this theory. Tricyclic antidepressants work in
people with IBS by reducing their sensitivity to pain in the gastrointestinal (GI) tract as well as normalizing their
GImotility and secretion.
Lubiprostone (Amitiza) for people who have IBS-C to improve abdominal pain or discomfort and constipation
symptoms.
Linaclotide (Linzess) for people who have IBS-C to relieve abdominal pain and increase how often you have bowel
movements.
The antibiotic rifaximin to reduce bloating by treating small intestinal bacterial overgrowth. However, experts are still
debating and researching the use of antibiotics to treat IBS.
Coated peppermint oil capsules to reduce IBS symptoms.
Follow your doctors instructions when you use medicine to treat IBS. Talk with your doctor about possible side effects and
what to do if you have them.
Some medicines can cause side effects. Ask your doctor and your pharmacist about side effects before taking any
medicine. MedlinePlus maintains the latest information about side effects and drug warnings.
Probiotics
Your doctor may also recommend probiotics. Probiotics are live microorganismstiny organisms that can be seen only with
a microscope. These microorganisms, most oftenbacteria, are like the microorganisms that are normally present in your GI
tract. Studies have found that taking large enough amounts of probiotics, specifically Bifidobacteria and certain probiotic
combinations, can improve symptoms of IBS. However, researchers are still studying the use of probiotics to treat IBS.
You can find probiotics in dietary supplements, such as capsules, tablets, and powders, and in some foods, such as yogurt.
Discuss your use of complementary and alternative medical practices, including probiotics and dietary supplements, with
your doctor.
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Therapies for mental health problems
Psychological therapies may improve your IBS symptoms.
Managing Stress
Learning to reduce stress can help improve IBS. With less stress, you may find you have less cramping and pain. You may
also find it easier to manage your symptoms.
Some options for managing stress include
taking part in stress reduction and relaxation therapies such as meditation

getting counseling and support
taking part in regular exercise such as walking or yoga
reducing stressful life situations as much as possible
getting enough sleep
Talk Therapy
Talk therapy may reduce stress and improve your IBS symptoms. Two types of talk therapy that health care professionals
use to treat IBS are cognitive behavioral therapy and psychodynamic, or interpersonal, therapy. Cognitive behavioral
therapy focuses on your thoughts and actions. Psychodynamic therapy focuses on how your emotions affect your IBS
symptoms. This type of therapy often involves relaxation and stress management techniques.
Gut-Directed Hypnotherapy
In gut-directed hypnotherapy, a therapist uses hypnosis to help you relax the muscles in the colon.
Mindfulness Training
Mindfulness training can teach you to focus your attention on sensations occurring at the moment and to avoid
catastrophizing, or worrying about the meaning of those sensations.
Eating, Diet, & Nutrition for Irritable Bowel Syndrome
How can my diet treat the symptoms of IBS?
Eating smaller meals more often, or eating smaller portions, may help your irritable bowel syndrome (IBS) symptoms. Large
meals can cause cramping and diarrhea if you have IBS.
Eating foods that are low in fat and high in carbohydrates, such as pasta, rice, whole-grain breads and cereals, fruits, and
vegetables, may help.
Fiber may improve constipation symptoms caused by IBS because it makes stool soft and easier to pass. Fiber is a part of
foods such as whole-grain breads and cereals, beans, fruits, and vegetables. The U.S. Department of Agriculture and U.S.
Department of Health and Human Services state in itsDietary Guidelines for Americans, 2010 that adults should get 22 to
34 grams of fiber a day.3
While fiber may help constipation, it may not reduce the abdominal discomfort or pain of IBS. In fact, some people with IBS
may feel a bit more abdominal discomfort after adding more fiber to their diet. Add foods with fiber to your diet a little at a
time to let your body get used to them. Too much fiber at once can cause gas, which can trigger symptoms in people with
IBS. Adding fiber to your diet slowly, by 2 to 3 grams a day, may help prevent gas and bloating.
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What should I avoid eating to ease IBS symptoms?
Certain foods or drinks may make symptoms worse, such as
foods high in fat

some milk products
drinks with alcohol or caffeine
drinks with large amounts of artificial sweeteners
beans, cabbage, and other foods that may cause gas
To find out if certain foods trigger your symptoms, keep a diary and track
what you eat during the day

what symptoms you have
when symptoms occur
Take your notes to your doctor and talk about which foods seem to make your symptoms worse. You may need to avoid
these foods or eat less of them.
Your doctor may recommend that you try a special dietcalled low FODMAP or FODMAPto reduce or avoid certain
foods containing carbohydrates that are hard to digest. Examples of high FODMAP foods and products you may reduce or
avoid include
fruits such as apples, apricots, blackberries, cherries, mango, nectarines, pears, plums, and watermelon, or juice
containing any of these fruits
canned fruit in natural fruit juice, or large quantities of fruit juice or dried fruit
vegetables such as artichokes, asparagus, beans, cabbage, cauliflower, garlic and garlic salts, lentils, mushrooms,
onions, and sugar snap or snow peas
dairy products such as milk, milk products, soft cheeses, yogurt, custard, and ice cream
wheat and rye products
honey and foods with high-fructose corn syrup
products, including candy and gum, with sweeteners ending in ol, such as
sorbitol
mannitol
xylitol
maltitol
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What causes painful menstruation?
13 possible conditions
Menstruation is a monthly occurrence for women in which the body sheds the lining of the uterus (womb), which is then
passed through a small opening in the cervix and out through the vaginal canal. Read more
1.Heavy, Prolonged, or Irregular Menstrual Periods
The duration and severity of menstrual bleeding varies from woman to woman. It's known as menorrhagia if a woman's
menstrual period is excessively heavy, prolonged, or irregular.
Read more
2.Endometriosis
Image attribution
Endometriosis is a disorder in which the tissue that forms the lining of your uterus grows outside of your uterine cavity. The
lining is called the endometrium.
Read more
3.Fibroids
Fibroids are abnormal growths that develop in or on a woman's uterus. Learn about fibroids' major indicators, including
heavy bleeding, pelvis pain, cramping, and bloating.
Read more
4.What is Fertility?
Infertility means you haven't gotten pregnant after a year of trying. If you're a woman over 35, it means you haven't gotten
pregnant after six months.
Read more
5.Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease (PID) is an infection of the reproductive organs in women. It's marked by pain in the abdomen,
especially during urination or sex.
Read more
6.Depression Overview
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Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a
person's everyday activities. It is estimated that depression affects 1 in 20 Americans.
Read more
7.Stress And Anxiety
Stress and anxiety are a normal part of life, but in some people, they can become bigger issues. Learn what causes stress
and anxiety and how to manage them.
Read more
8.What is Fibromyalgia?
Fibromyalgia is a disorder tied to widespread pain in your muscles and bones, areas of tenderness, and fatigue. Learn
about its symptoms, treatment, and more.
Read more
9.Anxiety
Learn more about anxiety with this overview of anxiety disorders.

Read more
10.PMS (Premenstrual Syndrome)
Premenstrual syndrome causes a wide variety of emotional and physical symptoms. Learn more about it.
Read more
11.Necrotizing Vasculitis
Necrotizing vasculitis is the inflammation of blood vessel walls. It can interrupt blood flow, causing skin, muscle, and blood
vessel damage.
Read more
12.Polycystic Kidney Disease
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Polycystic kidney disease is an inherited kidney disorder. It causes fluid-filled cysts to form in the kidneys. It may impair
kidney function.
Read more
13.Hypoparathyroidism
Image attribution
Hypoparathyroidism is a rare condition that occurs when the parathyroid glands in the neck don't produce enough
parathyroid hormone (PTH).
Read more
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Hiatal Hernia
What is a hiatal hernia?

Highlights
1. A hiatal hernia occurs when the upper part of your stomach pushes up through your diaphragm and into your chest
region.
2. There are generally two types of hiatal hernia: sliding and fixed.
3. This condition mostly occurs in people who are over 50 years old.
A hiatal hernia occurs when the upper part of your stomach pushes up through your diaphragm and into your chest region.
The diaphragm is a large muscle that lies between your abdomen and chest. You use this muscle to help you breathe.
Normally, your stomach is below the diaphragm, but in people with a hiatal hernia, a portion of the stomach pushes up
through the muscle. The opening it moves through is called a hiatus.
This condition mostly occurs in people who are over 50 years old. It affects up to 60 percent of people by the time theyre 60
years old, according to the Esophageal Cancer Awareness Association.
What causes a hiatal hernia?

The exact cause of many hiatal hernias isnt known. In some people, injury or other damage may weaken muscle tissue.
This makes it possible for your stomach to push through your diaphragm.
Another cause is putting too much pressure (repeatedly) on the muscles around your stomach. This can happen when:
coughing
vomiting
straining during bowel movements
lifting heavy objects
Some people are also born with an abnormally large hiatus. This makes it easier for the stomach to move through it.
Factors that can increase your risk of a hiatal hernia include:
obesity
aging
smoking
Types of hiatal hernia

There are generally two types of hiatal hernia: sliding hiatal hernias and fixed, or paraesophageal, hernias.
Sliding hiatal hernia
This is the more common type of hiatal hernia. It occurs when your stomach and esophagus slide into and out of your chest
through the hiatus. Sliding hernias tend to be small. They usually dont cause any symptoms. They may not require
treatment.
Fixed hiatal hernia
This type of hernia isnt as common. Its also known as a paraesophageal hernia.
In a fixed hernia, part of your stomach pushes through your diaphragm and stays there. Most cases are not serious.
However, there is a risk that blood flow to your stomach could become blocked. If that happens, it could cause serious
damage and is considered a medical emergency.
Symptoms of a hiatal hernia

Its rare for even fixed hiatal hernias to cause symptoms. If you do experience any symptoms, theyre usually caused by
stomach acid, bile, or air entering your esophagus. Common symptoms include:
heartburn that gets worse when you lean over or lie down
chest pain or epigastric pain
trouble swallowing
belching
Medical emergencies
An obstruction or a strangulated hernia may block blood flow to your stomach. This is considered a medical emergency.
Call your doctor right away if:
you feel nauseated
youve been vomiting
you cant pass gas or empty your bowels
Dont assume that a hiatal hernia is causing your chest pain or discomfort. It could also be a sign of heart problems or
peptic ulcers. Its important to see your doctor. Only testing can find out what is causing your symptoms.
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What is the connection between GERD and hiatal hernias?
Gastroesophageal reflux disease (GERD) occurs when the food, liquids, and acid in your stomach end up in your
esophagus. This can lead to heartburn or nausea after meals. Its common for people with a hiatal hernia to have GERD.
However, that doesnt mean either condition always causes the other. You can have a hiatal hernia without GERD or GERD
without a hernia.
Testing for and diagnosing hiatal hernias

Several tests can diagnose a hiatal hernia.
Barium X-ray
Your doctor may have you drink a liquid with barium in it before taking an X-ray. This X-ray provides a clear silhouette of
your upper digestive tract. The image allows your doctor to see the location of your stomach. If its protruding through your
diaphragm, you have a hiatal hernia.
Endoscopy
Your doctor may slide a thin tube in your throat and pass it down to your esophagus and stomach. Your doctor will then be
able to see if your stomach is pushing through your diaphragm. Any strangulation or obstruction will also be visible.
Treatment options for hiatal hernias
Most cases of hiatal hernias dont require treatment. The presence of symptoms usually determines treatment. If you have
acid reflux and heartburn, you may be treated with medications or, if those dont work, surgery.
Medications
Medications your doctor may prescribe include:
over-the-counter antacids to neutralize stomach acid
over-the-counter or prescription H2-receptor blockers that lower acid production
over-the-counter or prescription proton pump inhibitors to prevent acid production, giving your esophagus time to
heal
Surgery
If medications dont work, you might need surgery on your hiatal hernia. However, surgery is not commonly recommended.
Some types of surgery for this condition include:
rebuilding weak esophageal muscles
putting your stomach back in place and making your hiatus smaller
To perform surgery, doctors either make a standard incision in the chest or abdomen, or use laparoscopic surgery, which
shortens recovery time.
Hernias can come back after surgery. You can reduce this risk by:
staying at a healthy weight
getting help lifting heavy objects
avoiding strain on your abdominal muscles
Lifestyle changes
Acid reflux causes most hiatal hernia symptoms. Changing your diet can reduce your symptoms. It may help to eat smaller
meals several times a day instead of three large meals. You should also avoid eating meals or snacks within a few hours of
going to bed.
There are also certain foods that may increase your risk of heartburn. Consider avoiding:
spicy foods
chocolate
foods made with tomatoes
caffeine
onions
citrus fruits
alcohol
Other ways to reduce your symptoms include:
stopping smoking
raising the head of your bed by at least 6 inches
avoiding bending over or lying down after eating
Reducing your risk of hiatal hernias
You may not avoid a hiatal hernia entirely, but you can avoid making a hernia worse by:
losing excess weight
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not straining during bowel movements
getting help when lifting heavy objects
avoiding tight belts and certain abdominal exercises
Hiatal Hernia: Hidden Cause of Chronic Illness
When people are new to natural healing, they can often feel overwhelmed by the various supplements and modalities that
are available. Often, they just don't know where to beginespecially when there are so many different companies and
healers telling you to buy our products!
Although I do sell herbs and nutritional supplements, there are many things that are important to improving health that don't
involve swallowing something. In fact, there is one key to helping people improve their health that has solved more health
problems than anything else I've ever learned. It has helped me resolve cases where people had been to numerous doctors
and healers but had made no progress. It is an underlying problem in all chronic illness. This problem is tension in the solar
plexus and/or a hiatal hernia.
My own health improved dramatically when Jack Ritchason taught me about the hiatal hernia (also called a hiatus hernia),
and pulled mine down. At the same time, I learned about the ileocecal valve and how to fix that, too. Learning to fix these
problems was the single biggest key to improving my health and has been a big key in improving the health of others, too.
Before I learned how to fix this problem, I had to be extremely careful about what I ate and I had to take a lot of herbs and
supplements to stay healthy. I also had to do a lot of cleansing. Even then, my health was not as good as I would have liked
it to be.
Once my hiatal hernia was fixed and my ileocecal valve was closed, I found that I could eat a wider variety of foods without
suffering a negative impact to my health. I also had to take less than half as many herbs and supplements to get the same
results. When this was corrected, I had more energy, gained muscle mass and felt better overall.
Jack taught me that all chronically ill people have a hiatal hernia. I'm not sure that this is the case, but I do know that nearly
all chronically ill people have tension at the solar plexus that is interfering with digestion and breathing. Whether this
condition would be considered a full-blown hiatal hernia by the medical profession or not, I don't know.
What is a Hiatal Hernia?
The esophagus passes through an opening in the diaphragm muscle called the hiatus. The esophagus ends where it
connects to the stomach. The stomach lies in the abdominal cavity below the diaphragm. What a person has a hiatal hernia,
a portion of the stomach protrudes up into the chest cavity through the opening for the
esophagus (as pictured below).
The diaphragm muscle is supposed to contract downward into the abdominal cavity to
expand the chest area when we inhale. As the diaphragm relaxes upward, we exhale.
This is why a baby's tummy rises and falls when they are breathing. The movement of the
diaphragm causes the abdomen to expand outward when we inhale and relax inward as
we exhale.
When the stomach is in the way of the diaphragm, it can't move like it is supposed to, so
the person can't take a deep abdominal breath. In order for the person with a hiatal hernia
to take a deep breath, they must lift their chest and shoulders.
This is what I do to determine if a person has a hiatal hernia. First, I ask them to take a deep breath. If they breathe
upwards into their chest, I show them how to breathe abdominally and ask them to try it. A person who has a hiatal hernia
cannot take an abdominal breatheven when I try to coach them how to do it.
Chronically ill people are almost universally chest breathers. Occasionally, with a little coaching they can take a little bit of
an abdominal breath, but even then it is strained, suggesting that they may have a partial hiatal hernia. Some chest
breathers seem able to be taught how to breathe abdominally and can do it with coaching. This suggests they don't have a
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hiatal hernia, but they still have tension in the solar plexus, which is inhibiting breathing. I believe this tension is adversely
affecting digestion, too, even though the problem is not actually a hiatal hernia.
Check yourself, right now. Place one hand on your abdomen and one hand on your chest. Take a deep breath. Your chest
should move only slightly, but your abdomen should expand outward noticeably when you inhale. If your chest expands
outward and your stomach pulls inward when you take a deep breath, you probably have a hiatal hernia or at least tension
in the solar plexus.
Medical literature suggests that 1-20% of the population have a hiatal hernia, but about 95% of the people I see have
problems breathing deeply from their diaphragm. While this doesn't mean they have a medically-diagnosable hiatal hernia,
it does suggest they have problems with both breathing and digestion that are contributing to their health problems.
Problems Caused by a Hiatal Hernia
The first problem a hiatal hernia creates is shallow breathing. Shallow breathing increases acidity in the body because
breathing is the first line of pH buffering. Shallow breathing also increases pain, since pain is usually a sign of lack of
oxygen to the tissues. Shallow breathing reduces energy levels, because the cells need oxygen to create energy. A low
oxygen environment is ideal for the growth of bacteria, parasites and cancer cells. In short, lack of oxygen is one of the
primary causes of chronic illnessa cause that is overlooked by most people who are selling nutritional supplements or
teaching people about nutrition or health.
That's bad enough, but the problem doesn't stop there. Besides causing shallow breathing, the hiatal hernia also inhibits
digestion. It causes stress on the nerves to the stomach, which reduces secretion of acid and enzymes. As a result, proteins
are not properly digested and minerals are not properly absorbed. This is why people with severe hiatal hernias lack muscle
tone and are often very sickly. Many young people with this problem are excessively thin, while older people tend to be
overweight with poor muscle tone.
Depending on how far up into the diaphragm a person's stomach protrudes, a hiatal hernia may or may not cause problems
with acid reflux. If the stomach is in certain positions, the sphincter at the top of the stomach will not close properly to hold
acid in the stomach. In my experience, people with chronic acid reflux always have a hiatal hernia. However, the reverse is
not truenot everyone with a hiatal hernia experiences acid reflux.
The ironic thing is that people with hiatal hernias don't produce enough hydrochloric acid to properly digest food, but
because they are prone to acid indigestion, heartburn and acid reflux, they are frequently neutralizing what little acid they do
produce with antacids and acid blockers. The result is a vicious downward spiral of declining digestive function and general
health.
The Ileocecal Valve
The problems we've discussed so far are directly caused by the hiatal hernia, but there are also numerous secondary
problems caused by this condition. For instance, a hiatal hernia will often cause frequent gas and bloating. This is because
improperly digested protein will accumulate in the intestinal tract and contribute to intestinal irritation and inflammation.
Poorly digested food irritates the ileocecal valve (which separates the small intestine from the colon) causing it to become
inflamed. When the ileocecal value is inflamed, it swells and the swelling prevents it from shutting properly. This allows
bacteria from the colon migrate into the small intestines and feast on the sugars in the small intestine. This will cause
severe gas and bloating. I've relieved many severe cases of bloating just by
closing the ileocecal valve.
An open ileocecal valve is like having your septic tank or the sewer back up into
your kitchen. Not a very pleasant thought is it? About 95% of all people with a
hiatal hernia also have an open ileocecal valve, although occasionally you'll find
one without the other. An open ileocecal valve weakens the entire body.
You can locate the ileocecal valve by drawing an imaginary line from your belly
button to the protrusion of bone on the front of your right hip. The ileocecal valve
is located just under the halfway point along this line. Find this point right now
and press inward. If you feel pain when you press on this spot, you probably have an open ileocecal valve. You can close it
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by massaging this area using small circular movements while breathing deeply. When the pain goes away, the valve is
closed. You'll probably need to do this at least once a day for a few weeks to keep it closed.
Other Problems Related to a Hiatal Hernia
If the hiatal hernia protrudes upward far enough, it puts pressure on the bottom of the heart. Occasionally, I have seen
people with a rapid or irregular heartbeat which cleared up when their hiatal hernia was fixed. Also, Jack Ritchason taught
me that a large percentage of heart attacks (about 50%) are triggered by intestinal gas and bloating putting pressure on the
heart via a hiatal hernia. So, add cardiac problems to the list of potential problems from a hiatal hernia.
Since the esophagus has to be shortened because the stomach is protruding upward, this can cause a slight kink in the
esophagus. This often happens in the throat area, which can cause the sensation of a lump in the throat. It can also cause
difficulty in swallowing food or capsules. If this kink in the esophagus occurs near the thyroid, it can irritate the thyroid. In
younger people, this can cause the rapid metabolism that makes them very thin. In older people, it can cause low thyroid
and excess weight.
The shallow breathing and lack of hydrochloric acid (HCl) production can cause an over acid pH in the body, which makes a
person more susceptible to infection. Lack of HCl also makes one more prone to infection because HCl kills infectious
organisms in the stomach so they can't reach the small intestines. Lack of HCl also makes one more prone to fungal
infections.
Improper digestion of proteins and lack of proper mineral absorption have more subtle and far-reaching effects. For starters,
a hiatal hernia weakens the immune system and makes one more prone to infectious diseases, autoimmune conditions and
cancer. It also weakens the structural system, causing more problems with arthritis, back pain, osteoporosis and other
structural problems. Improperly digested proteins also contribute to chronic respiratory problems such as chronic sinus
congestion, allergies and asthma. The glandular system is also weakened.
In muscle testing some clients, I've found that nearly every system of the body tested weak. Just by working on the hiatal
hernia, I've had most of these systems test strong again. Clearly, the hiatal hernia weakens the whole body, so I think
instead of saying, death begins in the colon, we should say, death begins in the stomach.
Correcting a Hiatal Hernia
A hiatal hernia is a mechanical problem. You can't fix it just by taking nutritional supplements. You have to mechanically
manipulate the stomach downward from the diaphragm. The handout on the facing page offers several suggestions on how
this can be done. All of the listed techniques actually work. Feel free to duplicate and share this handout.
In addition to the techniques listed in the handout, let me offer a few additional ideas.
First, I have found dandelion flower essence to be very helpful in relaxing the muscle tension at the solar plexus that
accompanies a hiatal hernia. There is often a noticeable relaxing of the area and a deepened breathing after just one
dose.
Massaging the abdomen will also help this problem. Concentrate on massaging downward from below the rib cage.
This can be done from a standing position or while lying down.
Practicing deep breathing will also help fix a hiatal hernia. I often have to coach clients on how to breathe. Concentrate
on pushing your belly out as you breathe in. As you exhale, suck in your belly and pull your diaphragm upward. Exhale
as deeply as you can. This helps release the diaphragm and make the next breath fuller and deeper. It may even help
release the hiatal hernia. Exhaling fully may also help the stomach to slide back down into place. Since practicing
exhaling more deeply my lung capacity has greatly increased. This is another trick I learned from DeAnna Hansen
(developer of the Love Your Body Beautiful self-massage techniques).
Dealing with Causes
The question naturally arises, what causes a hiatal hernia? The problem is typically attributed to physical issues, such as
excess weight, pregnancy, lifting heavy objects, constipation and frequent coughing. I've observed that a large percentage
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of women in their 8-9th month of pregnancy develop this problem. Many obese people also have this problem. However,
those who seem to have it the worst are usually very thin, not pregnant or overweight, which suggests other causes.
Jack Ritchason and other natural healers often attribute the problem to intestinal gas and bloating putting pressure on the
stomach, but I think that this gas and bloating are not primary causes of the problem. They may aggravate it, but they aren't
the cause.
Stress, however, is a big factor. I read once that people with hiatal hernias often have a hard time expressing anger. They
swallow it instead of expressing it or finding constructive ways of dealing with it. I believe this is getting closer to the real
cause of a hiatal hernia, since I have found that doing anger release work will often relax the stomach immediately.
The Hiatal Hernia and Gut Instincts
For a long time I accepted that idea that the hiatal hernia was linked with suppressed anger, but I discovered that there is a
deeper problem at worknot paying attention to one's guts. In other words, not listening to one's instincts.
You've probably heard the phrase gut instinct. Well we all have gut instincts because we have a gut brain. The nervous
system and the digestive system develop from the same embryonic tissue and the guts produce neurotransmitters just like
the brain. There are also more nerves sending messages from the intestines to the brain than there are nerves sending
messages from the brain to the intestines.
Most people in modern Western society don't pay much attention to the messages their guts are sending. But, guts can and
do speak to us, and we can learn to listen by paying attention to the solar plexus.
The solar plexus is the soft area just underneath the breastbone and above the stomach. This area marks the place where
a network of nerves radiating outward in all directions like the rays of the sun, hence, the term solar plexus. At the Las
Vegas exhibition Bodies (which displays actually bodies and organs preserved through a special plastic) I got a chance to
see the solar plexus nerves and it really is a fascinating nervous structure.
In muscle testing, a muscle weakens when something is wrong and tests strong when things are good or right. The
solar plexus is an internal system of muscle testing that is constantly responding to the same subtle influences one picks up
with muscle testing. The solar plexus tenses when something is wrong and relaxes when something is all right. The tension
makes us hold our breath and the relaxation helps us breathe deeply.
Native people learned to depend on this knot in the stomach to warn them of danger and guide them to safety. Soldiers in
war often report that learning to pay attention to this has saved their lives by warning them of danger.
You can observe the solar plexus response at work by doing an experiment with essential oils. Get a variety of essential
oils and find a test subject. Have the person stand up straight and close their eyes. Then, pass an open bottle of some
essential oil under their nose so they can smell it.
If the oil has a positive effect, you'll see them relax a bit, breathe more deeply and lean forward slightly. If the oil has a
negative effect on them, you'll see them tense a bit, breathe more shallowly and lean slightly backwards. This
observable reaction will center on the response of the solar plexus to the oil. Try several different oils to observe
different reactions.
Body versus Brain
Most people in Western society live primarily in their heads. In fact, nearly all of us have received the message since
childhood that the body and its feelings or emotions are not to be trusted. As a result of this training, we learn to live in our
heads, believing the things we have been taught and ignoring the messages we receive from our body and our emotions.
In fact, Western society places the mind as pre-eminent and the body and heart as secondary. Descartes said, I think,
therefore I am, and Western civilization has considered thinking to be the seat of being ever since. Traditional Christianity
generally considers the body to be evil and the soul (or mind) to be pure. This is true even in new age circles, where
people are taught that we are mind and the body is an illusion.
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Even in the human potential movement, the body and its feelings are given a second place rating. Those who talk about
the Law of Attraction (as discussed in the DVD, The Secret and the movie What the Bleep?) typically say that thoughts
create feelings and feelings create actions. In other words, feelings and the physical body are just effectsmind is cause.
Even in modern science, which teaches that mind or soul are just chemical processes in the physical body, the idea that the
body and its feelings have something to tell us is scoffed at.
Wherever we look there appears to be a universal bias against the body and emotions. Culturally, then, we live in our heads
and trust book knowledge over subjective experience. No wonder we don't listen to our guts.
I'd like to make the case that body, mind and spirit are equally important, completely interactive, and that the mind is not the
only source of knowing. Yes, we can learn and do things through our mind, but the guts (which represent the body) and
the heart (which represents the spirit or soul), know things the head does not.
There is emerging scientific evidence for this viewpoint. Research is showing that we have a gut brain and that every part
of our body thinks or has intelligence. However, rather than talking about the science, let me give you a practical example
from my own life about the value of listening to one's guts.
A Personal Experience with Listening to My Guts
About a year or two after I first learned about the solar plexus response I was driving back to Roosevelt from Salt Lake City
here in Utah. It was late at night and I was traveling in a friend's car. Right after leaving Heber City, my solar plexus knotted
up. I knew this meant that something was wrong, but I didn't know what.
I started asking questions mentally, Is it this? Is it that? The knot in my stomach just kept getting tighter and tighter, and I
was getting more and more concerned. What was wrong? After about five minutes of trying to figure it out, I suddenly saw
the real' gas gauge. What I thought was the gas gauge was actually the temperature gauge. The gas gauge was on empty.
As soon as I realized I was nearly out of gas, the knot in my stomach relaxed and I breathed a sigh of relief. (That's how
your solar plexus lets you know you've got it right.) I turned the car around and went back to Heber City to fill up the tank.
It's about 80 miles from Heber City to Roosevelt, and there is only one gas station on that entire stretch of roadand it isn't
open at night. I would have run out of gas on a lonely stretch of road in the middle of nowhere late at night if my solar plexus
hadn't alerted me to the fact that something was wrong.
Since that experience, I've learned to pay attention to my solar plexus more and it has helped me out in many situations. I
believe the solar plexus is the body's way of talking to you. As with muscle testing, the body is sensing the vibrations of
influences around you and picking up information through the various senses. When the body senses vibrations or inputs
that are dangerous, it responds through the solar nerve plexus and we feel something in our abdomen.
Besides listening to the solar plexus, where the body talks to us, I also believe that we should listen to the heart, where our
emotions talk to us. The heart also produces hormones and neurotransmitters and thus, thinks. My heart has told me
things many times that my head couldn't understand, but things have always turned out better when I've listened to my
heart and not allowed my head to override it.
Both the heart and the body are able to sense things that the physical brain doesn't know how to process into words. Words
are secondary to experience, simply being a representation of experience. We should trust experience over words and the
subjective experience of our own heart and gut instincts over the word-based knowledge that we were programmed with
since childhood.
Gut Knowing and the Hiatal Hernia
It's time to wrap this all up and explain what I believe to be the underlying cause of the hiatal hernia and why it appears to
be universally present in chronic illness. Let's just suppose for a moment that I am correct when I say that the solar plexus
response is our internal muscle testing sensor that is designed to tell us what is good for us and what we should avoid.
Every time we go to do something that is harmful to our body (and thus to our health) the solar plexus is going to tense up.
This pulls the stomach upward and tenses it against the diaphragm. If we were listening, we would look around and try to
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figure out where the harmful influence was. As soon as we identified the source of harm or danger, the solar plexus would
relax again.
However, we don't listen. We just ignore the message. Thus, day after day we are doing things that cause our solar plexus
to tense up. Over time, this builds into a chronic tension that interferes with breathing and digestion. At the least, we
develop chronic tension in the solar plexus. At worst, we develop a hiatal hernia and its attending problems. The constant
harm we do to the body also leads to chronic illness.
If we were paying attention to what the body is trying to tell us, we would be able to avoid most harmful influences.
However, we have been taught to override the wisdom of the body and replace it with the learning of the brain. Few
people, even in the natural health movement, actually try to listen to their body. It's all about head knowledge.
It takes courage to follow your instincts. It takes real courage to chose to not do something that everyone else says is
perfectly safe when your instinct tells you it's not. It takes courage to not fall in with the groupfamily, friends, religion,
societyand make choices that are different because of what your instincts and heart are telling you. This is especially
true when you can't logically justify why you are making those choices, when it's just a feeling you have.
That's why they call it guts. Courage takes guts. Do you have the guts to listen to the wisdom of your body and heart?
Do you have the courage to make a choice that you can't logically justify because something simply feels right or wrong?
That's really having guts. I encourage you to stop ignoring the tension in your solar plexus and start doing the things that
allow it to relax. I guarantee that both your digestion and your health will improve.
Self-Help Corrections for a Hiatal Hernia
Start by checking your breathing. Accessing your pattern of breathing is the first step in correcting a hiatal hernia. Put
your hand on your abdomen as you breathe. If your abdomen moves in and out more than your chest, you are probably
handling your stress well, or at least, you aren't letting stress control you. You probably don't have a hiatal hernia, either.
If you are breathing from the top of your lungs, just sit back and relax to allow your breathing apparatus to revert to normal
abdominal breathing. If it doesn't, then you need to relax the diaphragm and help your stomach move downward. To do this,
take lobelia essence or blue vervain in liquid form. Then, practice breathing from the abdomen again. You can also practice
abdominal breathing while relaxing in a bath with lavender oil. It is also helpful to massage your abdomen, especially in the
area under the rib cage while concentrating on breathing deeply.
When you are practicing breathing deeply, practice exhaling completely. Force as much air out of your lungs as you
possibly can before inhaling again. This both exercises and relaxes the diaphragm and will help bring down the stomach.
Find healthy ways to vent your repressed anger and frustration. This releases tension from the diaphragm and will help
defuse much of the tension maintaining the hiatal hernia problem. For example, try taking a long, slow deep breath and feel
the tension build up in your diaphragm (like you are starting to get angry). Make your hands into fists and raise them up in
front of you as if you want to punch somebody. Exhale forcefully with an angry huh! sound while shaking your fists
downward like you are hitting something. Do this several times, safely discharging your inner tension and frustrations.
You can also throw a mini-temper tantrum. Again breathe in deeply, clench your fists like you are angry and then as you
exhale, yell, scream or just use a sound like "arrr" while shaking your fists and stomping your feet like a little child throwing
a tantrum. This may sound really stupid, and may be very hard for you to do, but I've seen the stomach come down and the
diaphragm noticeably relax after someone has done this.
Other methods of dealing with stress include changing your environment, finding new ways to resolve problems and
communicating your thoughts and feelings honestly with others.
It is also possible to bring down a hiatal hernia using manual manipulation. Find a chiropractor a massage therapist who
knows how to manually manipulate a hiatal hernia. You can also massage your own abdomen daily for about 5-15 minutes
paying special attention to massaging the area under your ribs.
As an alternative, the following technique can be used as a self-help form of manual manipulation.
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Drink a pint of warm water first thing in the morning.
Next, stand on your toes and drop suddenly to your heels several times. The force of this little jump and the weight of
the water help pull the stomach down in place while the warm temperature of the water relaxes the stomach area.
Taking a dropper full of lobelia essence with the water will relax the stomach and make the treatment more effective.
If you're adventurous, jump off a chair or down a short flight of stairs to get the same effect. The idea behind this technique
is to get your stomach to drop as if you were in an elevator that suddenly started going down. If this doesn't solve the
problem, place both hands under your breastbone in the center of your rib cage.
Take a deep breath and press your fingers firmly into the solar plexus area (just under the breastbone). As you
forcefully exhale, push your fingers downward and bend forward slightly. Be careful not to push your fingers up under
the rib cage. Repeat this action several times. Do this before meals on an empty stomach.
It is usually important to work on the ileocecal value when correcting the hiatal hernia. This valve is located on the right
side of the abdomen midway between the belly button and the right hip bone. Just start massaging in that area and if
there is any pain or discomfort in that region gently massage the area while breathing deeply until the pain goes away.
Do this at least once a day.
Finally, although nutritional supplements won't correct a hiatal hernia, they will help it heal as you mechanically get the
stomach to move downward. Supplements can also help the ileocecal value, which will help the hiatal hernia to heal, too.
The companies that make these supplements are listed in parenthesis after the supplement(s).
Red raspberry is a very good herb for toning abdominal muscles and is useful to take in capsules or teas when
correcting a hiatal hernia. Trace mineral supplements such as Colloidal Minerals, Mineral Chi Tonic or HSN-W (NSP)
will also be helpful in promoting healing from a hiatal hernia. To correct the ileocecal value problem and improve the
hiatal hernia problem at the same time I have found two formulas to be helpful. One is Intestinal Soothe and Build and
the other is Spleen Activator. Slippery elm is also useful here.
People who suffer from a hiatal hernia also benefit from taking digestive enzymes. My favorites are Proactazyme
(NSP), Digestazon Plus (Amazon) and Absorb-Aid (a health food store brand).
To treat hiatal hernia syndrome that is accompanied by heartburn, use slippery elm powder mixed with a little juice or
water or whole leaf aloe vera juice. If you continue to get acid in your throat, sleep with your head and chest slightly
elevated. Elevate your pillow to raise your head and chest.
I find flower essence to be very helpful in correcting the underlying emotional issues that contribute to a hiatal hernia.
Dandelion flower essence in particular is very helpful, which is interesting to me as Jack Ritchason taught me that
dandelion was a very good herb for people with a hiatal hernia. Dandelion flower essence is for people who are two
"uptight." They over form and over plan their lives and don't know how to relax and "go with the flow." I've seen
dandelion flower essence alone noticeably relax the diaphragm after just one dose.
Chamomile and St. John's wort are two other herbs that regulate the solar plexus and both can be helpful as flower
essences for correcting a hiatal hernia. Chamomile is helpful for promoting a more relaxed, even and "sunny"
disposition while St. John's wort helps people get in touch with their "gut instincts." Both are helpful as herbs, too.
Finally, I might mention that people with the thyroid-type body build (tall and thin) usually have the most problems with a
hiatal hernia. They also tend to have adrenal weakness and the two problems (adrenal weakness and a hiatal hernia) seem
to go hand in hand. Building the adrenals helps one manage stress better, so I also recommend that people with a hiatal
hernia work on building up their adrenal glands, too. Adrenal Support and Nervous Fatigue Formula (NSP) are the two
supplements I use most often for this purpose. However, licorice root and adaptagenic herbs like Eleuthero root are also
helpful.
Hiatus Hernia
DIGESTIVE DISORDERS - Hiatus hernia
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Hiatus hernia medically means the herniation/popping of stomach into the chest through a hole in the diaphragm. The
abdomen contents are entirely covered and separated completely from the chest by this thick tense muscular fibrous
sheath the diaphragm. It allows food tube to communicate with the stomach and blood vessels to communicate with the
lower parts through appropriate tight openings. None other can slip into the chest in normal condition, since openings tightly
hold the food tube or vessels.
However, when diaphragm gets weakened or if intra abdominal pressure dominates, hiatus hernia can occur. In the case of
hiatus hernia, the stomach as such starts getting into the chest following the food tube or in another way. More than the
pressure symptoms in chest due to the bulge or symptoms of stomach that herniates, the more one suffers due to hiatus
hernia is the food tube the oesophagus.
Nature had created each and everything with a special character in our human body. The natural architecture of the human
food tube is one such. The food tube can propel food into the stomach even in the upside down position. In the same
manner, non-return valve at the junction of the lower end of the food tube and upper (cardiac) end of stomach will not allow
even water in the reverse direction even if the stomach is full. The natural architecture that prevents back flow of food is by
the following mechanisms:
Oesophagus enters (ends in) stomach in an oblique manner. This oblique joining/ junction enhances the tight closure of
valve while the stomach gets distended or filled up.
Stomach lies in the abdomen i.e., completely below the diaphragm. The one-way valve also lies below the diaphragm. So,
the high intra-abdominal pressure will also influence this valve for tight closure to avoid back flow.
Usually, hiatus hernia lets the food tube valve go above the diaphragm. Thus losing natural controls, the valve ends in
relaxation and permission of food and acid contents from stomach into the lower end of the food tube. This ends further in
ulceration and causing burning volcano in the chest heart burn. These symptoms often mimic symptoms of heart
problems. So, hiatus hernia keeps patients constantly annoyed with the suspicion of heart trouble.
Types Hiatus hernia usually arises in two types. They are
Sliding hernia is the most common type of hiatus hernia. It is the herniation of stomach in a sliding manner into the chest,
i.e., it just slips up into the chest following the food tube. It can occur while lifting weight, straining, bending or lying down.
Bulging or rolling hernia is bulging of stomach through a weak point of diaphragm.
Incidences and causes Hiatus hernias are reward of strain or injury or increased abdominal pressure. Overeating,
overstraining, overweight, overtightening may cause hiatus hernia. Strained defecation, strained urination, strained cough,
strained vomiting, etc., can also cause hiatus hernia.
Hiatus hernias are more common in adults and rare in children. Females after the age of menopause have usually higher
incidences. The diaphragm will get weakened with age, constant increased intra abdominal pressure, overeating, multiple
pregnancy, etc. Irrespective of sex, obese and aged persons with the habit of smoking and drinking alcohol will suffer more
from hiatus hernia. Sometimes, congenital short oesophagus can also cause sliding hiatus hernia.
Symptoms Usually hiatus hernia will not produce any symptoms in the initial stages. However, it can cause discomfort in
the chest and stomach as hernia increases in size. The major symptoms are
Ball like sensation or chest oppression after meal.
Sometimes ball like sensation seems to be raising in chest (due to crawling food tube)
Burning pain behind the breast bone (retro sternum pain) with sour eructations
Belching often with chest discomfort
Difficulty in swallowing and even a small hand full meal seems to fill the abdomen
Indigestion, nausea and vomiting (of food/occasionally blood)
Anaemia and weight loss when left untreated for a prolonged time
Complaint usually aggravated or triggered by lying down and bending.
Diagnosis Hiatus hernia can be easily identified with its symptoms of aggravation following a heavy meal. Anyway,
detailed evaluation by a gastroenterologist is required to reveal the condition clearly and to proceed for apt treatment.
Following tests will give a clear idea about hiatus hernia and its intensity.
Barium meal X-ray series to confirm hiatus hernia and its nature of swelling. Also it can rule out obstruction/strictures, if
any.
Endoscopy tests to confirm oesophagus ulcerations and hiatus hernia
Biopsy of the ulcers (if any) to rule out cancer or presence of H. pylori
Ultrasound abdomen scan to rule out other organ involvement (gall bladder and pancreas, liver, etc)
MRI helps in difficult cases to get diagnosed
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Finally, it is not out of place to rule out heart involvement by checking BP and ECG
Complications The repeated acid reflux due to regurgitation in case of hiatus hernia will often cause recurrent ulcerations
in lower end of oesophagus. These ulcers often bleed continuously in small quantity to cause anaemia. Also constant ulcer
intends to raise the risk of cancer. Even then, these ulcers heal; they heal with scar which narrows the oesophagus to cause
difficulty in swallowing. Weight loss results finally due to reduced intake and anaemia.
Management
DO
Try to lose weight as first line of management in case of hiatus hernia.
Have meals slowly in a relaxed manner, without any hurry or tension
Stand or sit erect after eating
Sleep in 45 degree elevated bed or keep high pillows while sleeping
Go for a relaxed walk after diet
TAKE
Easily digestible and oil free diet to reduce the work load of stomach
Plenty of juices
Meal never more than 3/4th of the stomach
Small meal often to neutralise the acid load in the stomach to avoid acid reflux
AVOID
Tight waist belt
Stooping, bending, lying down, lifting weights and doing exercise upside down
Habits of smoking, drinking and chewing tobacco
Food containing high spices, chilies, pepper, and sausages
Aerated drinks, coffee and tea
Overeating/full meal, oily food, pickles and fatty snacks before bed time
Drugs like NSAIDs / pain-killers / birth control pills / nitrates
General treatment for heartburn Hiatus hernia as such produces only pressure symptoms or discomfort feeling whereas
recurrent acid reflux causes oesophagitis, oesophageal bleeding, strictures and obstruction in lower end of oesophagus. So
to avoid / arrest this acid reflux, most of the patients are prescribed only antacids or H2 blockers as management or
treatment with habit and diet recommendations.
Surgery In resistant and very painful cases, surgery is advised as a last resort to remove ulcerated / sclerosed /
constricted oesophagus and to repair diaphragm to correct hiatus hernia. This surgical procedure will improve dietary intake
immediately. Advanced laparoscopic surgery can answer this hiatus hernia in an easier way.
Homeopathic approach to acidity Without putting off the fire, covering the fire is like adding fuel to it for a dangerous
event. Managing hiatus hernia only with antacids and without any stress and strain limitation will lead one straightaway to
the surgeons table. So, habit alternation and dietary changes should be followed strictly to manage hiatus hernia whatever
the medicine or system followed.
Hiatus hernia need not be operated upon if it is in the initial stages, as it can be easily managed with Homeopathic
medicines. Even though scientific evidence wont prove reduction in size of hiatus hernia, hiatus hernia can be managed
with Homeopathic medicines with respect to symptoms. Homeopathy gives importance to patient symptoms rather than
disease symptoms. It also gives importance to patients sensations like ball / raising ball-like sensation in the chest, block in
the chest, gurgling and rolling of wind, relief from belching / flatus or not, difficulty in bringing up wind, appetite, nausea,
cravings, aversions, aggravating factors, ameliorating factors, etc. As cure is impossible hiatus hernia can be managed well
symptomatically by the use of Homeopathic medicines.
In severe cases, where most of the stomach enters the chest, there is need for surgery. Sometimes even after surgery,
feeling of discomfort, chest tightness may continue to persists due to repair done to the diaphragm. Also one should be
aware that even after surgery one has to restrict strain as before. So, it is better to adopt strain restriction, habit alternation
and dietary changes in the start-up stage itself, to manage the complaints without the surgeons knife.
Homeopathic medicines commonly used in cases of hiatus hernia are Acid nit, Ambra G, Antim crud, Arg Nit, Ars alb,
Asafoetida, Baptisia, Borax, Bryonia, Capsicum, Carbo veg, Causticum, China, Cocculus, Colocynth, Condurango,
Hydrastis, Ignatia, Ipecac, Iris vers, Kali bich, Lycopodium, Nat mur, Nat phos, Nux Vom, Phosphorus, Pulsatilla, Rhus tox,
Robinia, Silicea, Sulphur, Symphytum, etc. These Medicines should be taken under the advice and diagnosis of a qualified
Homeopath.
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Gallstones
Overview
Gallstones can lurk inside your gallbladder. Many people have gallstones and never know it. Gallstones are hard deposits in
your gallbladder, a small organ that stores bile, which is a digestive fluid made in the liver. Gallstones may consist of
cholesterol, salt, or bilirubin, which is discarded red blood cells. Gallstones range in size. They can be as small as a grain of
sand or as large as an apricot.
What Causes Gallstones?

The components in bile can crystallize and harden in your gallbladder, leading to gallstones. According to Harvard Health
Publications, 80 percent of gallstones are made of cholesterol. The other 20 percent of gallstones are made of calcium salts
and bilirubin. These are known as pigment stones.
Cholesterol Stones
Gallstones may develop when there is too much cholesterol in the bile secreted by your liver. Bile usually dissolves or
breaks down cholesterol. However, if your liver makes more cholesterol than your bile can dissolve, hard stones may
develop.
Bilirubin
Bilirubin is a chemical produced when your liver destroys old red blood cells. Some conditions, such as cirrhosis of the liver
and certain blood disorders, cause your liver to produce more bilirubin than it should. Stones form when your gallbladder
cannot break down the excess bilirubin. These hard substances are also called pigmented stones.
Concentrated Bile
Your gallbladder needs to empty bile to be healthy and function properly. If it fails to empty its bile content, the bile becomes
overly concentrated, which causes stones to form.
Who Is at Risk for Gallstones?

While your body produces cholesterol naturally, you can also take in excess cholesterol through your diet. Many risk factors
for gallstones are related to diet. These include:
being overweight or obese
eating a diet thats high in fat or cholesterol
rapid weight loss within a short period of time
eating diet thats high in fiber
having diabetes mellitus
Other risk factors include:
being female
being of American Indian or Mexican-American descent
being pregnant
having a family history of gallstones
being age 60 or older
having cirrhosis of the liver
taking certain medications for lowering cholesterol
taking medications that have a high estrogen content
Dont stop taking any medicines unless you have discussed it with your doctor.
What Are the Symptoms of Gallstones?

You may not experience any symptoms if you have gallstones. According to the American College of Gastroenterology
(ACG), 80 percent of people who have gallstones dont have any pain at all. These are called silent gallstones. Your
doctor may find these stones in your gallbladder from X-rays or performing surgery on your abdomen.
Some people do have gallstone symptoms. The most common symptom of gallstones is pain in the right upper quadrant of
your abdomen. The pain often radiates to your back or right shoulder or shoulder blade.
Other symptoms include:
fever
a yellowish tint in your skin or eyes, which can indicate jaundice
nausea or vomiting
clay-colored stools
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What Are the Stages of Gallbladder Disease?
Extreme gallstone pain is known as a gallbladder attack. This extreme pain lasts more than one to two hours. Gallstones
themselves dont cause this pain. It occurs when the gallstones block the movement of bile from the gallbladder. This
doesnt usually happen overnight. Instead, there are three stages that lead to the attack.
In stage 1, gallstones form in the gallbladder. Usually, theres no pain in this stage.
In stage 2, you start to experience gallbladder pain from time to time. You may notice this when you eat foods that
are high in fat, such as fried foods. The pain doesnt usually extend past a few hours. Other symptoms can include
stomach pain, burping, diarrhea, nausea, and indigestion.
In stage 3, a gallstone blocks the duct where bile moves from the gallbladder, a gallbladder attack occurs. This
stage is a medical emergency. Symptoms can include intense stomach or back pain, fever, chills, or appetite loss.
According to the American College of Gastroenterology (ACG), the risk of silent gallstones causing a gallbladder attack is 1
percent annually. For every 100 people that have silent gallstones, 10 of those people will have an attack within a decade.
How Are Gallstones Diagnosed?

Your doctor will perform a physical examination that includes checking your eyes and skin for visible changes in color. A
yellowish tint in your skin or eyes may be signs of jaundice. Too much bilirubin in your body causes jaundice.
The examination may involve using diagnostic testing to see inside your body. These tests include:
Ultrasound
Ultrasound tests produce images of your abdomen. This is the preferred imaging method to initially confirm that you have
gallstone disease.
Abdominal CT Scan
This is an imaging test that takes pictures of your liver and abdominal region.
Gallbladder Radionuclide Scan
This is a very important scan that takes about one hour to complete. A specialist injects a radioactive substance into your
veins. The substance travels through your blood to the liver and gallbladder. It highlights any infection or blockages in these
organs.
Blood Tests
Your doctor may order blood tests that measure the amount of bilirubin in your blood. The tests also help determine how
well your liver is functioning.
Find a Doctor
How Are Gallstones Treated?

Your doctor may use any of several treatment options to remove stones or improve your condition.
Surgery
Surgery is often the first option if you have significant symptoms.
Your doctor may need to perform a laparoscopic gallbladder removal, which is a common surgery. General anesthesia is
usually required for gallbladder removal. The surgeon will usually make three or four incisions on your abdomen. Your
surgeon will insert a small, lighted device into one of the incisions and carefully remove your gallbladder.
You usually go home on the day of the procedure if you have no complications.
Medications
Drugs that dissolve gallstones caused by cholesterol are an option if you cannot undergo surgery. These medications may
take several years to eliminate the gallstones.
Lifestyle Changes After Gallbladder Removal
Much like an appendix, a gallbladder isnt necessary for a person to live a full and healthy life. However, you may have
loose or watery stools after gallbladder removal.
This diarrhea occurs because removing a gallbladder involves rerouting the bile from the liver to the small intestine. Bile no
longer goes through the gallbladder after surgery and it becomes less concentrated. The result is a laxative effect that
causes diarrhea. If you eat a diet lower in fats, less bile will be released. Examples of dietary steps you can take include:
Reduce your intake of fats. Choose low-fat foods whenever possible. Avoid high-fat, greasy, and fried foods.
Add fiber to your diet. Extra fiber can make your bowel movements less liquid. Try to add only a serving of fiber at a
time to prevent gas that can occur from eating excess fiber.
Avoid foods and drinks known to cause diarrhea, such as caffeine, high-fat dairy products, and very sweet foods.
Eat several small meals per day instead of large meals. Smaller meals are easier for the body to digest.
Can I Prevent Gallstones?
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You cant prevent gallstones, but you can reduce your risk with lifestyle strategies. Eat a balanced diet. Dont skip meals.
Drink sufficient amounts of water each day to keep your body hydrated. If you plan to lose weight, do it slowly. Aim to lose
no more than two pounds per week. Rapid weight loss may increase your risk of gallstones and other health problems.
What Can I Expect in the Long Term?

Surgery to remove your gallbladder or any stones in your gallbladder is often successful. In most cases, stones dont return.
However, if you dont have surgery, the gallstones can return. This is true even when youve taken medicines to dissolve the
gallstones.
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Hernia
What is a hernia?
A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the
intestines may break through a weakened area in the abdominal wall.
Hernias are most common in the abdomen, but they can also appear in the upper thigh, belly button, and groin areas. Most
hernias are not immediately life threatening, but they dont go away on their own and can require surgery to prevent
potentially dangerous complications.
Common hernia types

Inguinal hernia
Inguinal hernias are the most common type of hernia. They make up about 70 percent of all hernias, according to the British
Hernia Centre (BHC). These hernias occur when the intestines push through a weak spot or tear in the lower abdominal
wall, often in the inguinal canal.
The inguinal canal is found in your groin. In men, it is the area where the spermatic cord passes from the abdomen to the
scrotum. This cord holds up the testicles. In women, the inguinal canal contains a ligament that helps hold the uterus in
place.
This type of hernia is more common in men than in women. This is because a mans testicles descend through the inguinal
canal shortly after birth, and the canal is supposed to close almost completely behind them. Sometimes, the canal does not
close properly and leaves a weakened area prone to hernias.
Hiatal hernia
A hiatal hernia occurs when part of your stomach protrudes up through the diaphragm into your chest. The diaphragm is a
sheet of muscle that helps you breathe by contracting and drawing air into the lungs. It separates the organs in your
abdomen from those in your chest.
This type of hernia is most common in patients over 50 years old. If a child has the condition, its typically caused by a
congenital (birth) defect. Hiatal hernias almost always cause gastroesophageal reflux, which is when the stomach contents
leak backward into the esophagus, causing a burning sensation.
Umbilical hernia
Umbilical hernias can occur in children and babies under 6 months old. This happens when their intestines bulge through
their abdominal wall near their bellybutton. You may notice a bulge in or near your childs bellybutton, especially when
theyre crying.
An umbilical hernia is the only kind that often goes away on its own, typically by the time the child is 1 year old. If the hernia
has not gone away by this point, surgery may be used to correct it.
Incisional hernia
Incisional hernias can occur after youve had abdominal surgery. Your intestines may push through the incision scar or the
surrounding, weakened tissue.
What causes a hernia?

Hernias are caused by a combination of muscle weakness and strain. Depending on its cause, a hernia can develop quickly
or over a long period of time.
Common causes of muscle weakness include:
failure of the abdominal wall to close properly in the womb, which is a congenital defect
age
chronic coughing
damage from injury or surgery
Factors that strain your body and may cause a hernia, especially if your muscles are weak, include:
being pregnant, which puts pressure on your abdomen
being constipated, which causes you to strain when having a bowel movement
heavy weight lifting
fluid in the abdomen, or ascites
suddenly gaining weight
persistent coughing or sneezing
Am I at risk for a hernia?

The factors that increase your risk of developing a hernia include:
a personal or family history of hernias
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being overweight or obese
a chronic cough
chronic constipation
smoking, which can trigger a chronic cough
Conditions such as cystic fibrosis can also indirectly increase your risk of developing a hernia. Cystic fibrosis impairs the
function of the lungs, causing a chronic cough.
What are the symptoms of a hernia?

The most common symptom of a hernia is a bulge or lump in the affected area. In the case of an inguinal hernia, you may
notice a lump on either side of your pubic bone where your groin and thigh meet. Youre more likely to feel your hernia
through touch when youre standing up.
If your baby has a hernia, you may only be able to feel the bulge when he or she is crying. A bulge is typically the only
symptom of an umbilical hernia.
Other common symptoms of an inguinal hernia include:
pain or discomfort in the affected area (usually the lower abdomen), especially when bending over, coughing, or lifting
weakness, pressure, or a feeling of heaviness in the abdomen
a burning, gurgling, or aching sensation at the site of the bulge
Other symptoms of a hiatal hernia include:
acid reflux, which is when stomach acid moves backward into the esophagus causing a burning sensation
chest pain
difficulty swallowing
In some cases, hernias have no symptoms. You may not know you have a hernia unless it shows up during a routine
physical or a medical exam for an unrelated problem.
How is a hernia diagnosed?

Inguinal or incisional hernias are usually diagnosed through a physical examination. Your doctor may feel for a bulge in your
abdomen or groin that gets larger when you stand, cough, or strain.
If you have a hiatal hernia, your doctor may diagnosed it with a barium X-ray or endoscopy. These tests allow your doctor to
see the internal location of your stomach:
A barium X-ray is a series of X-ray pictures of your digestive tract. The pictures are recorded after youve finished
drinking a liquid solution containing barium, which shows up well on the X-ray images.
An endoscopy involves threading a small camera attached to a tube down your throat and into your esophagus and
stomach.
If your child has an umbilical hernia, your doctor may perform an ultrasound. An ultrasound uses high-frequency sound
waves to create an image of the structures inside the body.
Treatment options for a hernia
Whether or not you need treatment depends on the size of your hernia and the severity of your symptoms. Your doctor may
simply monitor your hernia for possible complications. Treatment options for a hernia include:
Lifestyle changes
Dietary changes can often treat the symptoms of a hiatal hernia. Avoid large or heavy meals, dont lie down or bend over
after a meal, and keep your body weight in a healthy range.
If these changes in diet dont eliminate your discomfort, you may need surgery to correct the hernia. You can also improve
symptoms by avoiding foods that cause acid reflux or heartburn, such as spicy foods and tomato-based foods. Additionally,
you can avoid reflux by losing weight and giving up cigarettes.
Medication
If you have a hiatal hernia, over-the-counter and prescription medications that reduce stomach acid can relieve your
discomfort and improve symptoms. These include antacids,H-2 receptor blockers, and proton pump inhibitors.
Surgery
If your hernia is growing larger or causing pain, your doctor may decide that its best to operate. Your doctor may repair your
hernia by sewing the hole in the abdominal wall closed during surgery. This is most commonly done by patching the hole
with surgical mesh.
Hernias can be repaired with either open or laparoscopic surgery. Laparoscopic surgery uses a tiny camera and
miniaturized surgical equipment to repair the hernia using only a few small incisions. Laparoscopic surgery is less
damaging to the surrounding tissue.
Open surgery requires a longer recovery process. You may be unable to move around normally for up to six weeks.
Laparoscopic surgery has a much shorter recovery time. However, the risk of your hernia reoccurring is higher. In addition,
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not all hernias are suitable for laparoscopic repair, including those in which a portion of your intestines has moved down into
the scrotum.
Potential complications of a hernia

If left untreated, your hernia may grow and become more painful. A portion of your intestine could become trapped in the
abdominal wall. This can obstruct your bowel, causing severe pain, nausea, and constipation. An untreated hernia can also
put too much pressure on nearby tissues, which can cause swelling and pain in the surrounding area.
If the trapped section of your intestines doesnt get enough blood flow, strangulation occurs. This can cause the intestinal
tissue to become infected or die. A strangulated hernia is life-threatening and requires immediate medical care.
Preventing a hernia
You cant always prevent the muscle weakness that allows a hernia to occur. However, you can reduce the amount of strain
you place on your body. This may help you avoid a hernia or keep an existing hernia from getting worse. Prevention tips
include:
not smoking
seeing your doctor when youre sick to avoid developing a persistent cough
maintaining a healthy body weight
avoiding straining during bowel movements or urination
lifting objects with your knees and not your back
avoiding lifting weights that are too heavy for you
Outlook
Its important to recognize the early signs of a hernia. An untreated hernia will not go away on its own. However, with early
medical care or lifestyle changes, you can minimize the effects of a hernia and avoid life-threatening complications like
strangulation.
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What Do You Want to Know About Ovarian Cancer?
The ovaries are small, almond-shaped organs located on either side of the uterus. They are where eggs are produced.
Ovarian cancer can occur in several different parts of the ovary.
Ovarian cancer can start in the ovarys germ, stromal, or epithelial cells. Germ cells are the cells which become eggs.
Stromal cells function like connective tissue. They make up most of the ovary. Epithelial cells are the outer layer of the
ovary.
Ovarian cancer
Highlights
Ovarian cancer occurs when a tumor forms in the ovarys cells.
Tell your doctor about any symptoms youre having that may suggest ovarian cancer.
Ovarian cancer treatment involves a combination of therapies, such as surgery, chemotherapy, hormone therapy, and
radiation.
Ovarian cancer occurs in the ovarys cells. The ovaries are two female reproductive glands that produce ova, or eggs. They
also produce the female hormones estrogen and progesterone. Cancer starts when abnormal cells in the ovary begin to
multiply out of control and form a tumor. The tumor can then spread to other parts of the body. More than 22,000 women will
receive an ovarian cancer diagnosis in 2016, and 14,000 women will die from it.
Ovarian cancer often has warning signs, but the earliest symptoms are vague and easy to dismiss. Twenty percent of
ovarian cancers are detected at an early stage.
Types of ovarian cancer

The ovaries are made up of three types of cells. Each cell can develop into a different type of tumor:
Epithelial tumors form in the layer of tissue on the outside of the ovaries. About 90 percent of ovarian cancers are
epithelial tumors
Stromal tumors grow in the hormone-producing cells. Seven percent of ovarian cancers are stromal tumors.
Germ cell tumors develop in the egg-producing cells. Germ cell tumors are rare.
Ovarian cysts
Most ovarian cysts arent cancerous. These are called benign cysts. However, a very small number can be cancerous.
An ovarian cyst is a collection of fluid or air that develops in or around the ovary. Most ovarian cysts form as a normal part
of ovulation, which is when the ovary releases an egg. They usually only cause mild symptoms, like bloating, and go away
without treatment.
Cysts are more of a concern if you arent ovulating. Women stop ovulating after menopause. If an ovarian cyst forms after
menopause, your doctor may want to do more tests to find out the cause of the cyst, especially if its large or doesnt go
away within a few months.
If the cyst doesnt go away, your doctor may recommend surgery to remove it just in case. Your doctor cant determine if its
cancerous until they remove it surgically.
What are the early symptoms of ovarian cancer?

Its easy to overlook the early symptoms of ovarian cancer because theyre similar to other common illnesses or they tend
to come and go. The early symptoms include:
abdominal bloating, pressure, and pain
abnormal fullness after eating
difficulty eating
an increase in urination
an increased urge to urinate
Ovarian cancer can also cause other symptoms, such as:
fatigue
indigestion
heartburn
constipation
back pain
menstrual irregularities
painful intercourse
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These symptoms may occur for any number of reasons. They arent necessarily due to ovarian cancer. Many women have
some of these problems at one time or another. These types of symptoms are temporary and respond to simple treatments
in most cases.
The symptoms will persist if theyre due to ovarian cancer. Contact your doctor if you have one or more of these symptoms
for a significant period. Symptoms usually become more severe as the tumor grows. By this time, the cancer has usually
spread outside of the ovaries. This makes it much harder to treat effectively.
Risk factors for ovarian cancer

The exact cause of ovarian cancer is unknown. These factors can increase your risk:
a family history of ovarian cancer
genetic mutations of genes associated with ovarian cancer, such as BRCA1 or BRCA2
a personal history of breast, uterine, or colon cancer
obesity
the use certain fertility drugs or hormone therapies
no history of pregnancy
endometriosis
Older age is another risk factor. Most cases of ovarian cancer develop after menopause.
Its possible to have ovarian cancer without having any of these risk factors. Likewise, having any of these risk factors
doesnt necessarily mean youll get ovarian cancer.
How is ovarian cancer diagnosed?

Its much easier to treat ovarian cancer when your doctor diagnoses it in the early stages. However, its not easy to detect.
Your ovaries are situated deep within the abdominal cavity, so youre unlikely to feel a tumor. Theres no routine diagnostic
screening available for ovarian cancer. Thats why its so important for you to report unusual or persistent symptoms to your
doctor.
If your doctor is concerned that you have ovarian cancer, theyll likely recommend a pelvic exam. Performing a pelvic exam
can help your doctor discover irregularities, but small ovarian tumors are very difficult to feel. As the tumor grows, it presses
against the bladder and rectum. Your doctor may be able to detect irregularities during a rectovaginal pelvic examination.
Your doctor may also do the following tests:
A transvaginal ultrasound (TVUS) is a type of imaging test that uses sound waves to detect tumors in the
reproductive organs, including the ovaries. However, TVUS cant help your doctor determine if tumors are cancerous or
not.
Your doctor may order an abdominal and pelvic CT scan. If youre allergic to dye, they may order an MRI.
A blood test to measure cancer antigen 125 (CA-125) levels is useful in assessing treatment for ovarian cancer as
well as other reproductive organ cancers. However, menstruation, uterine fibroids, and uterine cancer can also affect
levels of CA-125 in the blood.
A biopsy involves removing a small sample of tissue from the ovary and analyzing the sample under a microscope.
A biopsy is the only way your doctor can confirm whether or not you have ovarian cancer.
What are the stages of ovarian cancer?

Your doctor determines the stage based on how far the cancer has spread. There are four stages, and each stage has sub-
stages:
Stage 1
Stage 1 ovarian cancer has 3 sub-stages:
The cancer is limited, or localized, to one ovary in stage 1A.
The cancer is in both ovaries in stage 1B.
In Stage 1C, there are also cancer cells on the outside of the ovary.
Stage 2
In stage 2, the tumor has spread to other pelvic structures. In stage 2A, the cancer has spread to the uterus or fallopian
tubes. In stage 2B, it has spread to the bladder or rectum.
Stage 3
Stage 3 ovarian cancer has three sub-stages:
In stage 3A, the cancer has spread beyond the pelvis to the lining of the abdomen and the lymph nodes in the
abdomen.
In stage 3B, the cancer cells are outside of the spleen or liver.
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In stage 3C, deposits of cancer at least 3/4 of an inch are seen on the abdomen or outside the spleen or liver. However,
the cancer isnt inside the spleen or liver.
Stage 4
In stage 4, the tumor has metastasized, or spread, beyond the pelvis, abdomen, and lymph nodes to the liver or lungs. In
stage 4A, the cancerous cells are in the fluid around the lungs. Stage 4B is the most advanced stage. In stage 4B, the cells
have reached the inside of the spleen or liver or even other distant organs like the skin or brain.
How ovarian cancer is treated

The treatment depends on how far the cancer has spread. A team of doctors will determine a treatment plan depending on
your situation. It will most likely include two or more of the following:
chemotherapy
radiation
surgery to stage the cancer and remove the tumor
targeted therapy
hormone therapy
Surgery
Surgery is the main treatment for ovarian cancer. The goal of surgery is to remove the tumor, but a hysterectomy, or
complete removal of the uterus is often necessary. Your doctor may also recommend removing both ovaries and fallopian
tubes, nearby lymph nodes, and other pelvic tissue. Identifying all tumor locations is difficult. In one study, researchers
investigated ways to enhance the surgical process so that its easier to remove all of the cancerous tissue.
Targeted therapy
Targeted therapies, such as chemotherapy and radiation treatments, attack the cancer cells while doing little damage to
normal cells in the body. Newer targeted therapies to treat advanced epithelial ovarian cancer
include bevacizumab (Avastin) and olaparib(Lynparza). Doctors only use olaparib in people with mutations in the BRCA
genes.
Ovarian cancer research and studies

New treatments for ovarian cancer are studied each year. Researchers are also exploring new ways to treat platinum-
resistant ovarian cancer. When platinum resistance occurs, standard first-line chemotherapy drugs like carboplatin and
cisplatin are ineffective.
Certain drugs are also studied for their potential benefits in ovarian cancer. A 2014 study examined targeted treatments for
those with more advanced stages of this cancer.
Ovarian cancer treatment primarily focuses on surgery to remove the ovaries and uterus, and chemotherapy. As a result,
some women will experience menopause symptoms. A recent study examined how hormone therapy (HT) affects quality of
life after ovarian cancer treatment. This study found that HT is safe for menopause treatments in women with ovarian
cancer. People in the study maintained a high quality of life while receiving HT after being treated for ovarian cancer.
A 2015 article looked at intraperitoneal (IP) chemotherapy. This study found that those who received IP therapy had a
median survival rate of 61.8 months. This was an improvement as compared to 51.4 months for those who received
standard chemotherapy.
What is the outlook?

Your outlook depends on a variety of factors, including the stage of the cancer at diagnosis, your overall health, and how
well you respond to treatment. Every cancer is unique, but the stage of the cancer is the most important indicator of outlook.
Survival rate
The survival rate is the percentage of women who survive a certain number of years at a given stage of diagnosis. For
example, the five-year survival rate is the percentage of patients who received a diagnosis at a particular stage and live at
least five years after their doctor diagnosed them. The relative survival rate also takes into account the expected rate of
death for people without cancer.
Epithelial ovarian cancer is the most common type of ovarian cancer. The American Cancer Society estimates the relative
survival rate for this type of ovarian cancer as:
Stage 1: 90 percent
1A: 94 percent
1B: 92 percent
1C: 85 percent
Stage 2: 70 percent
2A: 78 percent
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2B: 73 percent
Stage 3: 39 percent
3A: 59 percent
3B: 52 percent
3C: 39 percent
Stage 4: 17 percent
The survival rate is higher than 90 percent when the cancer is found early and treated right away. Doctors diagnose 15
percent of ovarian cancers at the earliest stages. Scientists are currently researching more improved and reliable ways to
detect ovarian cancer early.
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Secretin Stimulation Test
What Is Secretin?
When partially digested food from your stomach arrives in your small intestine, your small intestine produces a hormone
called secretin. Secretin makes your pancreas release a fluid that contains inactive digestive enzymes and bicarbonates.
This fluid moves from your pancreas into the upper portion of your small intestine, your duodenum. The fluids neutralize
your stomach acids to activate your pancreatic enzymes. These enzymes help your body break food down and absorb its
nutrients.
Some pancreatic diseases such as cystic fibrosis, chronic pancreatitis, and pancreatic cancer make it harder for your
pancreas to respond to secretin. When this happens, your pancreas cant deliver enough digestive enzymes to your small
intestine to help the digestion process. This is called pancreatic insufficiency.
Pancreatic Insufficiency
Cystic fibrosis (CF), pancreatitis, and pancreatic cancer can cause pancreatic insufficiency.
CF is a genetic disease. If you have CF, you may develop mucus in your lungs and pancreas. Mucus can obstruct the ducts
leading out of the pancreas and make it hard for your body to deliver pancreatic fluid to your duodenum. Children who have
pancreatic insufficiency often have CF. They may also be malnourished.
Pancreatitis is an inflammation of your pancreas. If you have pancreatitis, enzymes that are normally inactive until they
reach your small intestine become activated earlier. They start digesting while still in your pancreas. The symptoms of
pancreatitis include abdominal pain, nausea, and vomiting.
If you have chronic pancreatitis or pancreatic cancer, you may have damage to the cells that produce pancreatic enzymes.
You may also have damage to the duct that delivers these enzymes to your small intestine. This will lead to insufficient
pancreatic enzymes in your small intestine to properly digest food. In adults, pancreatic insufficiency is most commonly
associated with pancreatitis. However, less often, damage can also be caused by pancreatic cancer.
Diagnosing Pancreatic Disease

Your doctor will need to perform several tests to diagnose pancreatic diseases.
The secretin stimulation test can show them how your pancreas functions in response to secretin. It can help your doctor
learn how your pancreas works during digestion. Its also called the pancreatic function test.
This test is invasive and conducted only when other evidence suggests you have pancreatic insufficiency.
Preparing for the Test

Youll need to fast for 12 hours before your secretin stimulation test. Your doctor will ask you to avoid eating any food or
drinking any liquids, including water. Undergoing this test on an empty stomach reduces the risk of complications.
Test Procedure
Your doctor will test how your pancreas responds to secretin by inserting a tube through your nose, into your esophagus,
and through your stomach until it reaches your duodenum. Your doctor will then inject secretin intravenously into your body.
If your body releases pancreatic fluid in response to the secretin, that fluid will be removed through the tube sitting in your
duodenum within an hour or two.
Risks of the Test

You may experience irritation in your nose and a gagging sensation when your doctor inserts the tube. Theres also a small
risk that the tube could be inserted into your trachea and go into your lungs, instead of your esophagus. However, your
doctor will make sure the tube is placed correctly before continuing with the test.
Test Results
If your test results are abnormal, this means you have some degree of pancreatic insufficiency. Abnormal results may mean
you have CF, pancreatitis, or pancreatic cancer. However, abnormal results from this test alone are not enough for your
doctor to diagnose these diseases. Theyll need to perform other tests to learn whats causing your pancreatic insufficiency.
Its not easy to diagnose pancreatitis or pancreatic cancer. For one thing, many symptoms of pancreatitis are similar to
those of pancreatic cancer. Many of the symptoms arent specific to diseases of the pancreas either. They can point to a
number of different diseases. There are also different types of pancreatitis. You may have acute or chronic pancreatitis.
Each type requires different tests before your doctor can make a diagnosis.
If your doctor suspects you have pancreatitis, theyll probably conduct blood work. You may also undergo stool testing and
other imaging tests.
If you have chronic pancreatitis, you have a higher-than-normal risk of contracting pancreatic cancer. If your doctor believes
you might have pancreatic cancer, theyll order other tests, such as a biopsy of your pancreas.
The Takeaway
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Pancreatic disease often manifests with symptoms of abdominal pain, nausea, and vomiting. Your doctor can use several
tests to diagnose the cause of your symptoms. For example, the secretin stimulation test allows them to test how your
pancreas functions in response to secretin. This is an important hormone in the digestive process.
If your secretin stimulation test results are abnormal, you may have a pancreatic disease such as pancreatitis, pancreatic
cancer, or cystic fibrosis. Speak with your doctor to learn more about your diagnosis, treatment, and long-term outlook.
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Non-Hodgkin Lymphoma
Non-Hodgkin Lymphoma
Non-Hodgkin lymphoma (NHL) is a cancer of the lymphatic system. It occurs when tumors develop from the lymphocytes. A
lymphocyte is a type of white blood cell. NHL is more common than Hodgkins lymphoma.
The main difference between Hodgkins lymphoma and NHL is the presence of a type of abnormal cell called the Reed-
Sternberg cell. This type of abnormal cell is only present in Hodgkins lymphoma. Hodgkins lymphoma and NHL have very
different treatment options.
Many types of cancers can spread to the lymph nodes. However, only cancers that start in the lymph tissue are considered
lymphomas.
What Are the Symptoms of Non-Hodgkin Lymphoma?

The symptoms of NHL may include:
abdominal pain or swelling
chest pain
coughing
difficulty breathing
swollen lymph nodes
fatigue
a fever
night sweats
weight loss
You should always see your doctor anytime you experience persistent symptoms that concern you.
What Causes Non-Hodgkin Lymphoma?

Doctors and researchers dont know what causes NHL. It occurs when the body makes too many abnormal lymphocytes.
These abnormal cells dont die. They continue to grow and divide. This enlarges the lymph nodes.
Who Is at Risk for Non-Hodgkin Lymphoma?

Many people with NHL have no obvious risk factors. Its also possible to have multiple risk factors and never develop NHL.
Some factors that may increase NHL risk include:
older age, since most people are aged 60 or older when diagnosed
the use of immunosuppressant drugs
an infection, particularly with HIV, Epstein-Barr virus, or Helicobacter pylori
exposure to certain chemicals, such as weed and insect killers
How Is Non-Hodgkin Lymphoma Diagnosed?

Physical exams can be used to check the size and condition of your lymph nodes. They can also find an enlarged liver or
spleen. A number of tests can be used to diagnose NHL.
Your lymph nodes will swell any time your body is fighting an infection. Your doctor may order blood and urine tests to
determine what type of infection your body is fighting.
Imaging tests such as the following can be used to help your doctor look for tumors and stage the cancer:
X-rays
CT scans
MRIs
PET scans
A biopsy can remove a portion of the lymph node for testing. This can definitively identify NHL. A bone marrow biopsy can
help your doctor determine if the disease has spread.
What Are the Types of Non-Hodgkin Lymphoma?

There are many different types of NHL, and theyre categorized by how the cells look under a microscope. Most types of
NHL are categorized as either B-cell lymphoma or T-cell lymphoma.
The American Cancer Society (ACS) estimates that 85 percent of NHL cases are B-cell lymphomas. The most common
types of B-cell lymphomas are diffuse, large B-cell lymphoma, which accounts for 1 out of every 3 cases in the United
States and follicular lymphoma, which accounts for 1 out of every 5 cases in the United States.
The less common types of B-cell lymphoma include:
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Burkitts lymphoma
extranodal marginal zone B-cell lymphoma
lymphoplasmacytic mantle cell lymphoma
mediastinal large B-cell lymphoma
marginal zone B-cell lymphoma
small lymphocytic lymphoma
The ACS estimates that T-cell lymphomas make up 15 percent of lymphomas in the United States.
How Is Non-Hodgkin Lymphoma Treated?

Treatment for NHL depends on your age, the type of NHL you have, and the stage of NHL you have.
Immediate treatment isnt always necessary. Your doctor may just monitor NHL thats growing slowly and isnt causing
symptoms. Treatment can wait until the disease progresses.
More aggressive forms of NHL can be treated in several ways:
Chemotherapy can be given orally or by injection. It kills cancer cells. Chemotherapy may be used alone or with
other treatments.
Radiation involves the use of high-powered beams of energy to kill cancer cells and get rid of tumors. Radiation can
be used alone or with other treatments.
A stem cell transplant allows your doctor to use higher doses of chemotherapy. This treatment kills stem cells as
well as cancer cells. Then, your doctor uses a transplant to return healthy cells to the body. Your doctor can transplant
either your own cells or they can use donor cells. Your cells must be harvested in advance and frozen if your cells are
going to be used in the transplant.
Medications can be used to enhance the immune system. They can also be used to deliver radioactive isotopes
that bind to cancerous cells.
What Is the Outlook for People with Non-Hodgkin Lymphoma?

Survival rates for NHL vary. Your outlook will depend on:
your age
your overall health
the type of NHL you have
how soon the NHL is discovered
People with slower growing cancers can live a long time.
Sometimes, NHL isnt found until its in the advanced stages. Aggressive forms of NHL can usually be treated, but cancer
found in later stages can be difficult to treat. The cancer may be fatal before treatment has time to take effect.
Can Non-Hodgkin Lymphoma Be Prevented?

Theres no known way to prevent NHL. However, it may be possible to reduce your risk for the disease by avoiding known
risk factors such as obesity and HIV.
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Cystic Fibrosis
What Is Cystic Fibrosis?
Cystic fibrosis is a serious genetic condition that causes severe damage to the respiratory and digestive systems. This
damage often results from a buildup of thick, sticky mucus in the organs. The most commonly affected organs include the:
lungs
pancreas
liver
intestines
Cystic fibrosis affects the cells that produce sweat, mucus, and digestive enzymes. Normally, these secreted fluids are thin
and smooth like olive oil. They lubricate various organs and tissues, preventing them from getting too dry or infected. In
people with cystic fibrosis, however, a faulty gene causes the fluids to become thick and sticky. Instead of acting as a
lubricant, the fluids clog the ducts, tubes, and passageways in the body. This can lead to life-threatening problems,
including infections, respiratory failure, and malnutrition. Its critical to get treatment for cystic fibrosis right away. Early
diagnosis and treatment are critical for improving quality of life and lengthening the expected lifespan.
Approximately 1,000 people are diagnosed with cystic fibrosis every year in the United States. Although people with the
condition require daily care, they can still lead a relatively normal life and work or attend school. Screening tests and
treatment methods have improved in recent years, so many people with cystic fibrosis can now live into their 40s and 50s.
What Are the Symptoms of Cystic Fibrosis?

The symptoms of cystic fibrosis can vary depending on the person and the severity of the condition. The age at which
symptoms develop can also differ. Symptoms may appear at infancy, but for other children, symptoms may not begin until
after puberty or even later in life. As time passes, the symptoms associated with the disease may get better or worse.
One of the first signs of cystic fibrosis is a strong salty taste to the skin. Parents of children with cystic fibrosis have
mentioned tasting this saltiness when kissing their children.
Other symptoms of cystic fibrosis result from complications that affect:
the lungs
the pancreas
the liver
other glandular organs
Respiratory Problems
The thick, sticky mucus associated with cystic fibrosis often blocks the passageways that carry air into and out of the lungs.
This can cause the following symptoms:
wheezing
a persistent cough that produces thick mucus or phlegm
shortness of breath, especially when exercising
recurrent lung infections
a stuffy nose
stuffy sinuses
Digestive Problems
The abnormal mucus can also plug up the channels that carry the enzymes produced by the pancreas to the small
intestine. Without these digestive enzymes, the intestine cant absorb the necessary nutrients from food. This can result
in:
greasy, foul-smelling stools
constipation
nausea
a swollen abdomen
loss of appetite
poor weight gain in children
delayed growth in children
What Causes Cystic Fibrosis?

Cystic fibrosis occurs as a result of a defect in whats called the cystic fibrosis transmembrane conductance regulator
gene, or CFTR gene. This gene controls the movement of water and salt in and out of your bodys cells. A sudden mutation,
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or change, in the CFTR gene causes your mucus to become thicker and stickier than its supposed to be. This abnormal
mucus builds up in various organs throughout the body, including the:
intestines
pancreas
liver
lungs
It also increases the amount of salt in your sweat.
Many different defects can affect the CFTR gene. The type of defect is associated with the severity of cystic fibrosis. The
damaged gene is passed on to the child from their parents. In order to have cystic fibrosis, a child must inherit one copy of
the gene from each parent. If they only inherit one copy of the gene, they wont develop the disease. However, theyll be a
carrier of the defective gene, which means that they may pass the gene on to their own children.
Who Is at Risk for Cystic Fibrosis?

Cystic fibrosis is most common among Caucasians of Northern European descent. However, its known to occur in all ethnic
groups.
People who have a family history of cystic fibrosis are also at an increased risk because its an inherited disorder.
How Is Cystic Fibrosis Diagnosed?

In the United States, all newborns are screened for cystic fibrosis. Doctors use a genetic test or blood test to check for signs
of the disease. The genetic test detects whether your baby has a defective CFTR gene. The blood test determines whether
a babys pancreas and liver are working correctly. Other diagnostic tests that may be performed include:
Immunoreactive Trypsinogen (IRT) Test
The immunoreactive trypsinogen (IRT) test is a standard newborn screening test that checks for abnormal levels of the
protein called IRT in the blood. A high level of IRT may be a sign of cystic fibrosis. However, further testing is required to
confirm the diagnosis.
Sweat Chloride Test
The sweat chloride test is the most commonly used test for diagnosing cystic fibrosis. It checks for increased levels of salt in
the sweat. The test is performed by using a chemical that makes the skin sweat when triggered by a weak electric current.
Sweat is collected on a pad or paper and then analyzed. A diagnosis of cystic fibrosis is made if the sweat is saltier than
normal.
Sputum Test
During a sputum test, the doctor takes a sample of mucus. The sample can confirm the presence of a lung infection. It can
also show the types of germs that are present and determine which antibiotics work best to treat them.
Chest X-Ray
A chest X-ray is useful in revealing swelling in the lungs due to blockages in the respiratory passageways.
CT Scan
A CT scan creates detailed images of the body by using a combination of X-rays taken from many different directions.
These images allows your doctor to view internal structures, such as the liver and pancreas, making it easier to assess the
extent of organ damage caused by cystic fibrosis.
Pulmonary Function Tests (PFTs)
Pulmonary function tests (PFTs) determine whether your lungs are working properly. The tests can help measure how much
air can be inhaled or exhaled and how well the lungs transport oxygen to the rest of the body. Any abnormalities in these
functions may indicate cystic fibrosis.
How Is Cystic Fibrosis Treated?

Although theres no cure for cystic fibrosis, there are various treatments available that may help relieve symptoms and
reduce the risk of complications.
Medications
Antibiotics may be prescribed to get rid of a lung infection and to prevent another infection from occurring in the
future. Theyre usually given as liquids, tablets, or capsules. In more severe cases, injections or infusions of antibiotics
can be given intravenously, or through a vein.
Mucus-thinning medications make the mucus thinner and less sticky. They also help you to cough up the mucus so
it leaves the lungs. This significantly improves lung function.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and indomethacin, may help reduce any pain
and fever associated with cystic fibrosis.
Bronchodilators relax the muscles around the tubes that carry air to the lungs, which helps increase airflow. You can
take this medication through an inhaler or a nebulizer.
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Bowel surgery is an emergency surgery that involves the removal of a section of the bowel. It may be performed to
relieve a blockage in the bowels.
Cystic fibrosis may interfere with digestion and prevent the absorption of nutrients from food. A feeding tube to
supply nutrition can be passed through the nose or surgically inserted directly into the stomach.
A lung transplant involves removing a damaged lung and replacing it with a healthy one, usually from a deceased
donor. The surgery may be necessary when someone with cystic fibrosis has severe breathing problems. In some
cases, both lungs may need to be replaced. This can potentially lead to serious complications after surgery,
including pneumonia.
Surgical Procedures
Chest Physical Therapy
Chest therapy helps loosen the thick mucus in the lungs, making it easier to cough it up. Its typically performed one to four
times per day. A common technique involves placing the head over the edge of a bed and clapping with cupped hands
along the sides of the chest. Mechanical devices may also be used to clear mucus. These include:
a chest clapper, which imitates the effects of clapping with cupped hands along the sides of the chest
an inflatable vest, which vibrates at a high frequency to help remove chest mucus
Home Care
Cystic fibrosis can prevent the intestines from absorbing necessary nutrients from food. If you have cystic fibrosis, you
might need up to 50 percent more calories per day than people who dont the disease. You may also need to take
pancreatic enzyme capsules with every meal. Your doctor may also recommend antacids, multivitamins, and a diet high
in fiber and salt.
If you have cystic fibrosis, you should do the following:
Drink plenty of fluids because they can help thin the mucus in the lungs.
Exercise regularly to help loosen mucus in the airways. Walking, biking, and swimming are great options.
Avoid smoke, pollen, and mold whenever possible. These irritants can make symptoms worse.
Get influenza and pneumonia vaccinations regularly.
What Is the Long-Term Outlook for People with Cystic Fibrosis?

The outlook for people with cystic fibrosis has improved dramatically in recent years, largely due to advances in treatment.
Today, many people with the disease live into their 40s and 50s, and even longer in some cases. However, theres no cure
for cystic fibrosis, so lung function will steadily decline over time. The resulting damage to the lungs can cause severe
breathing problems and other complications.
How Can Cystic Fibrosis Be Prevented?

Cystic fibrosis cant be prevented. However, genetic testing should be performed for couples who have cystic fibrosis or
who have relatives with the disease. Genetic testing can determine a childs risk for cystic fibrosis by testing samples of
blood or saliva from each parent. Tests can also be performed on you if youre pregnant and concerned about your babys
risk.
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Peripheral Neuropathy
What is peripheral neuropathy?
Your peripheral nervous system connects the nerves from your brain and spinal cord, or central nervous system, to the rest
of your body. This includes your:
arms
hands
feet
legs
internal organs
mouth
face
The job of these nerves is to deliver signals about physical sensations back to your brain.
Peripheral neuropathy is a disorder that occurs when these nerves malfunction because theyre damaged or destroyed.
This disrupts the nerves normal functioning. They might send signals of pain when theres nothing causing pain, or they
might not send a pain signal even if something is harming you. This can be due to:
an injury
systemic illness
an infection
an inherited disorder
The disorder is uncomfortable, but treatments can be very helpful. The most important thing to determine is whether
peripheral neuropathy is the result of a serious underlying condition.
What are the symptoms of peripheral neuropathy?

The three types of peripheral nerves are:
sensory nerves, which connect to your skin
motor nerves, which connect to your muscles
autonomic nerves, which connect to your internal organs
Peripheral neuropathy can affect one nerve group or all three.
The symptoms of peripheral neuropathy include:
tingling in the hands or feet
a feeling like youre wearing a tight glove or sock
sharp, stabbing pains
numbness in the hands or feet
a weak, heavy feeling in the arms and legs, which sometimes may feel like your legs or arms lock in place
regularly dropping things from your hands
a buzzing or shocking sensation
thinning of the skin
a drop in blood pressure
sexual dysfunction, especially in men
constipation
digestive difficulty
diarrhea
excessive sweating
These symptoms can also indicate other conditions. Make sure you tell your doctor about all of your symptoms.
What are the causes of peripheral neuropathy?

People who have a family history of peripheral neuropathy are more likely to develop the disorder. However, a variety of
factors and underlying conditions may also cause this condition.
Generalized diseases
Nerve damage caused by diabetes is one of the most common forms of neuropathy. This leads to numbness, pain, and a
loss of sensation in the extremities. The risk of neuropathy increases for people who:
are overweight
have high blood pressure
are over the age of 40
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have diabetes
According to the University of Chicagos Center for Peripheral Neuropathy (UCCPN), nearly 60 percent of people with
diabetes have some sort of nerve damage. This damage is often due to high blood sugar levels.
Other chronic diseases that may cause nerve damage include:
kidney disorders in which high amount of toxins build up in the body and damage nerve tissue
hypothyroidism, which occurs when the body doesnt produce enough thyroid hormone, leading to fluid retention
and pressure surrounding nerve tissues
diseases that cause chronic inflammation and can spread to the nerves or damage connective tissue surrounding
nerves
deficiencies of vitamins E, B-1, B-6, and B-12, which are essential to nerve health and functioning
Injury
Physical trauma is the most common cause of injury to the nerves. This can include car accidents, falls, or fractures.
Inactivity, or holding still too long in one position, can also cause neuropathy. Increased pressure on the median nerve, a
nerve in the wrist that supplies feeling and movement to the hand, causes carpal tunnel syndrome. This is a common type
of peripheral neuropathy.
Alcohol and toxins
Alcohol can have a toxic effect on nerve tissue, putting people with severe alcoholism at a higher risk of peripheral
neuropathy.
Exposure to toxic chemicals like glue, solvents, or insecticides, either through chemical abuse or in the workplace, can also
cause nerve damage. Additionally, exposure to heavy metals such as lead and mercury can also cause this condition.
Infections and autoimmune disorders
Certain viruses and bacteria directly attack nerve tissue.
Viruses such as herpes simplex, varicella-zoster virus, which causes chickenpox and shingles, and Epstein-Barr virus
damage sensory nerves and cause intense episodes of shooting pain.
Bacterial infections such as Lyme disease can also cause nerve damage and pain if they arent treated. People with HIV or
AIDS can also develop peripheral neuropathy.
Autoimmune diseases like rheumatoid arthritis and lupus affect the peripheral nervous system in various ways. Chronic
inflammation and damage to tissues throughout the body, as well as pressure caused by inflammation, can all lead to
severe nerve pain in the extremities.
Medications
Certain medications may also cause nerve damage. These include:
anticonvulsants, which people take to treat seizures
drugs to fight bacterial infections
some blood pressure medications
medications used to treat cancer
Recent research in The Journal of Family Practice also suggests that statins, a class of drugs used to lower cholesterol and
prevent cardiovascular disease, may also cause nerve damage and increase the risk for neuropathy.
How is peripheral neuropathy diagnosed?

First, your doctor will perform a physical exam and ask about your medical history. If they still cant tell whether your
symptoms are due to peripheral neuropathy, other tests to perform include:
Blood tests can measure vitamin and blood sugar levels and determine whether your thyroid is functioning correctly.
Your doctor may also order a CT scan or MRI to see if anything is pressing on a nerve, such as a herniated disk or
a tumor.
Sometimes your doctor will order a nerve biopsy. This is a minor surgery that involves removing a small amount of
nerve tissue that they can then examine under a microscope.
Electromyography
Electromyography can show problems with how your bodys nerve signals move to your muscles. For this test, your doctor
will place a small needle into your muscle. Your doctor will then ask you to move your muscle gently. Probes in the needle
will measure the amount of electricity moving through your muscle. This test may feel like youre receiving a shot.
Sometimes the area becomes sore for a few days afterward.
Nerve conduction study
In a nerve conduction study, your doctor places electrodes on your skin. They then pulse tiny amounts of electricity through
your nerves to see if the nerves are transmitting signals properly. This procedure is slightly uncomfortable while its
happening, but it shouldnt hurt afterward.
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What are the treatment options for peripheral neuropathy?
The treatment is based on treating the underlying disorder. If diabetes is the cause, making certain that the blood glucose is
controlled is important. If a vitamin deficiency is causing the problem, then correcting the deficiency is the treatment. Many
treatments can bring relief and help you return to your regular activities. Sometimes a combination of treatments works
best.
Pain medications
Over-the-counter (OTC) pain medications like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs, such as
aspirin and ibuprofen, can be very helpful in controlling moderate pain. If you take them in excess, these drugs can affect
your liver or stomach function. Its important to avoid using them for an extended period, especially if you drink alcohol
regularly.
Prescription medications
Many prescription pain medications can also help to control the pain of this condition. These include narcotics, some
antiepileptic medicines, and some antidepressants. Other helpful prescription medicines include:
cyclooxygenase-2 inhibitors
tramadol
corticosteroid injections
seizure medications, such as gabapentin or pregabalin
antidepressants, such as amitriptyline
Cymbalta, which is a serotonin norepinephrine reuptake inhibitor
Prescription drugs for sexual dysfunction in men include:
sildenafil (Viagra)
vardenafil (Levitra, Staxyn)
tadalafil (Cialis)
avanafil (Stendra)
Medical treatments
Your doctor can use several medical treatments to control the symptoms of this condition. Plasmapheresis is a blood
transfusion that removes potentially irritating antibodies from your bloodstream. If you get a nerve block, your doctor will
inject an anesthetic directly into your nerves.
Transcutaneous electronic nerve stimulation (TENS)
Transcutaneous electronic nerve stimulation (TENS) doesnt work for everyone, but many people like it because its a drug-
free therapy. During TENS, electrodes placed on the skin send small amounts of electricity into the skin. The goal of this
treatment is to disrupt nerves from transmitting pain signals to the brain.
Ergonomic casts or splints
Ergonomic casts or splints can help you if your neuropathy affects your:
feet
legs
arms
hands
These casts provide support for the part of your body thats uncomfortable. This can relieve pain. For example, a cast or
splint that holds your wrists in a proper position while you sleep can relieve the discomfort of carpal tunnel syndrome.
Self-care
In addition to OTC pain relievers, many people have found relief for peripheral neuropathy through:
chiropractic care
acupuncture
massage
meditation
yoga
Moderate, regular exercise can also help lessen discomfort.
If you drink alcohol or smoke, consider cutting back or stopping. Both alcohol and tobacco aggravate nerve pain and can
cause nerve damage when used for long periods.
Take precautions at home
If you have peripheral neuropathy, youre potentially at greater risk for accidents in the home. You can do the following to
improve your safety:
Always wear shoes to protect your feet.
Keep your floor clear of things that you could trip on.
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Check the temperature of your bath or dishwater with your elbow, not your hand or foot.
Install handrails in your bathtub or shower.
Use bath mats that can prevent slipping.
Dont stay in one position for too long. Get up and move around a couple of times each hour. This is especially
important for those whose work involves sitting for long periods at a desk.
What is the long-term outlook?

If your neuropathy is due to an underlying, treatable condition, you may be able to stop your peripheral neuropathy by
treating the larger problem. However, if this isnt the case for you, you can successfully manage the symptoms of your
peripheral neuropathy. Speak with your doctor to determine the best medical treatment for you, and explore alternative and
self-care options that can supplement your medical care.
How can I prevent peripheral neuropathy?

Even if you have a family history of this disorder, you can help prevent its onset by doing the following:
avoiding alcohol or drinking it only in moderation
avoiding smoking or quitting smoking if you smoke
eating a healthy diet
getting regular, moderate exercise
You can lower your risk of peripheral neuropathy by:
knowing what toxins you might be exposed to at work or school
protecting your feet during sports, especially those that involve kicking
never inhaling toxins like glue to get high
If you have diabetes, take special care of your feet. Wash and inspect your feet daily, and keep the skin moist with lotion.
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Legionnaires' Disease
What Is Legionnaires Disease?

Legionnaires disease is a severe type of pneumonia, or lung infection. Bacteria calledLegionella cause this infection. The
bacteria were discovered after an outbreak at a Philadelphia convention of the American Legion in 1976. Those who were
affected developed a form of pneumonia that eventually became known as Legionnaires disease.
Legionella bacteria usually thrive in warm water. People become infected withLegionella by breathing in contaminated
droplets of water in the air. Outbreaks have been linked to water systems in hospital buildings and to whirlpool spas in
hotels and cruise ships.
Approximately 8,000 to 18,000 people are hospitalized in the United States each year for Legionnaires disease. However,
the number of infections is probably higher because many infections arent diagnosed or reported. Some cases are so mild
that affected individuals never seek treatment. The symptoms of Legionnaires disease are similar to those of other types
pneumonia. These symptoms may include fever, chills, and a cough.
Many people who are exposed to Legionella dont become sick. When illness does occur, however, its important to see a
doctor right away. Legionnaires disease is a serious, life-threatening illness that requires prompt treatment.
Legionella may also cause a more mild condition referred to as Pontiac fever. Pontiac fever doesnt cause pneumonia and
isnt life-threatening. It has symptoms similar to those of a mild flu, and it usually goes away on its own. Pontiac fever and
Legionnaires disease are sometimes collectively called Legionellosis.
What Are the Symptoms of Legionnaires Disease?

Legionnaires disease will usually start causing symptoms within two to 14 days after exposure to the bacteria. This period
is called the incubation period. The symptoms are similar to those of other types of lung infections.
The most common symptoms include:
a fever above 104F
chills
a cough, with or without mucus or blood
Other symptoms may include:
headaches
muscle aches
a loss of appetite
chest pain
fatigue
What Causes Legionnaires Disease?

Bacteria called Legionella cause Legionnaires disease. The bacteria invade the lungs and cause an infection known as
pneumonia.
Legionella usually live in warm freshwater. Common locations include:
hot tubs
whirlpool spas
swimming pools
cooling systems or air-conditioning units for large buildings, such as hospitals
public showers
humidifiers
fountains
natural bodies of water, such as lakes, rivers, and creeks
The bacteria can survive outdoors, but theyre known to multiply rapidly in indoor water systems. People get infected by
inhaling water droplets or mist in the air thats contaminated with the bacteria. The disease cant be spread directly from
person-to-person.
Who Is at Risk for Legionnaires Disease?

Not everyone who breathes in contaminated air droplets will get sick. However, youre at a higher risk for developing
Legionnaires disease if you:
are over age 65
have a weakened immune system due to another illness
have a chronic lung disease
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have a job that involves maintaining cooling or air conditioning systems
abuse alcohol
smoke cigarettes
What Are the Complications of Legionnaires Disease?

When Legionnaires disease goes untreated, life-threatening complications can develop. These include:
respiratory failure, which occurs when fluid builds up in the lungs
kidney failure, which develops when the kidneys arent working correctly
septic shock, which is a serious infection that leads to organ failure and very low blood pressure
These complications can progress rapidly, especially in people who already have weakened immune systems.
How Is Legionnaires Disease Diagnosed?

Your doctor can diagnose Legionnaires disease by testing your blood or urine for the presence of Legionella antigens.
Antigens are substances that your body recognizes as harmful. Your body produces an immune response to antigens to
fight infection. Your doctor may also test a sample of sputum, or phlegm, for the Legionella bacteria.
Your doctor might also perform a chest X-ray. While the X-ray cant be used to confirm Legionnaires disease, it can help
determine the severity of your lung infection.
How Is Legionnaires Disease Treated?

Legionnaires disease is always treated with antibiotics. Treatment is usually started as soon as the disease is suspected,
without waiting for confirmation. Prompt treatment significantly lowers the risk of complications.
Many people completely recover with treatment, but most will need care in the hospital. Elderly people and those with other
health conditions are particularly vulnerable to the effects of Legionnaires disease. While in the hospital, they may receive
oxygen or other breathing support. They may also be given fluids and electrolytes through a vein in their arm (IV) to prevent
dehydration.
What Is the Outlook After Treatment?

The outlook is typically good for healthy people who receive prompt treatment. However, the length of recovery time will
depend on the severity of the disease and how quickly treatment is received. Faster treatment means better results.
Legionnaires disease is usually more serious in elderly people who have weakened immune systems or other medical
conditions. If youre elderly, you have a higher risk of developing complications and you may need to stay in the hospital for
an extended period.
How Can Legionnaires Disease Be Prevented?

Theres no vaccine available for Legionnaires. However, its possible to prevent the disease by properly disinfecting and
cleaning potential sources of the Legionella bacteria. Preventive measures include:
disinfecting and cleaning cooling towers
regularly draining and cleaning pools and hot tubs
using chemical treatments, such as chlorine, in pools and spas
keeping hot water systems above 140F and cold water systems below 68F
Avoiding smoking can also significantly lower your risk of infection. Smokers are much more likely to develop Legionnaires'
disease if theyre exposed to Legionella bacteria.
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Polio
What is polio?
Polio (also known as poliomyelitis) is a highly contagious disease caused by a virus that attacks the nervous system.
Children younger than 5 years old are more likely to contract the virus than any other group.
According to the World Health Organization (WHO), 1 in 200 polio infections will result in permanent paralysis. However,
thanks to the global polio eradication initiative in 1988, the following regions are now certified polio-free:
Americas
Europe
Western Pacific
Southeast Asia
The polio vaccine was developed in 1953 and made available in 1957. Since then cases of polio have dropped in United
States.
HealthGrove | Graphiq
But polio is still persistent in Afghanistan, Pakistan, and Nigeria. Eliminating polio will benefit the world in terms of health
and economy. The eradication of polio can save at least $4050 billion over the next 20 years.
What are the symptoms of polio?

Its estimated that 95 to 99 percent of people who contract poliovirus are asymptomatic. This is known as subclinical polio.
Even without symptoms, people infected with poliovirus can still spread the virus and cause infection in others.
Non-paralytic polio
Signs and symptoms of non-paralytic polio can last from one to 10 days. These signs and symptoms can be flu-like and can
include:
fever
sore throat
headache
vomiting
fatigue
meningitis
Non-paralytic polio is also known as abortive polio.
Paralytic polio
About 1 percent of polio cases can develop into paralytic polio. Paralytic polio leads to paralysis in the spinal cord (spinal
polio), brainstem (bulbar polio), or both (bulbospinal polio).
Initial symptoms are similar to non-paralytic polio. But after a week, more severe symptoms will appear. These symptoms
include:
loss of reflexes
severe spasms and muscle pain
loose and floppy limbs, sometimes on just one side of the body
sudden paralysis, temporary or permanent
deformed limbs, especially the hips, ankles, and feet
Its rare for full paralysis to develop. Less than 1 percent of all polio cases will result in permanent paralysis. In 510 percent
of the polio paralysis cases, the virus will attack the muscles that help you breathe and cause death.
Post-polio syndrome
Its possible for polio to return even after youve recovered. This can occur after 15 to 40 years. Common symptoms of post-
polio syndrome (PPS) are:
continuing muscle and joint weakness
muscle pain that gets worse
becoming easily exhausted or fatigued
muscle wasting, also called muscle atrophy
trouble breathing and swallowing
sleep apnea, or sleep-related breathing problems
low tolerance of cold temperatures
new onset of weakness in previously uninvolved muscles
depression
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trouble with concentration and memory
Talk to your doctor if youve had polio and are starting to see these symptoms. Its estimated that 25 to 50 percent of people
who survived polio will get PPS. PPS cant be caught by others having this disorder. Treatment involves management
strategies to improve your quality of life and reduce pain or fatigue.
How does the poliovirus infect someone?

As a highly contagious virus, polio transmits through contact with infected feces. Objects like toys that have come near
infected feces can also transmit the virus. Sometimes it can transmit through a sneeze or a cough, as the virus lives in the
throat and intestines. This is less common.
People living in areas with limited access to running water or flush toilets often contract polio from drinking water
contaminated by infected human waste. According to the Mayo Clinic, the virus is so contagious that anyone living with
someone who has the virus can catch it too.
Pregnant women, people with weakened immune systems such as those who are HIV-positive and young children are
the most susceptible to the poliovirus.
If you have not been vaccinated, you can increase your risk of contracting polio when you:
travel to an area that has had a recent polio outbreak
take care of or live with someone infected with polio
handle a laboratory specimen of the virus
have your tonsils removed
have extreme stress or strenuous activity after exposure to the virus
How do doctors diagnose polio?

Your doctor will diagnose polio by looking at your symptoms. Theyll perform a physical examination and look for impaired
reflexes, back and neck stiffness, or difficulty lifting your head while lying flat.
Labs will also test a sample of your throat, stool, or cerebrospinal fluid for the poliovirus.
How do doctors treat polio?

Doctors can only treat the symptoms while the infection runs its course. But since theres no cure, the best way to treat polio
is to prevent it with vaccinations.
The most common supportive treatments include:
bed rest
painkillers
antispasmodic drugs to relax muscles
antibiotics for urinary tract infections
portable ventilators to help with breathing
physical therapy or corrective braces to help with walking
heating pads or warm towels to ease muscle aches and spasms
physical therapy to treat pain in the affected muscles
physical therapy to address breathing and pulmonary problems
pulmonary rehabilitation to increase lung endurance
In advanced cases of leg weakness, you may need a wheelchair or other mobility device.
How to prevent polio

The best way to prevent polio is to get the vaccination. Children should get polio shots according to the vaccination
schedule presented by the Centers for Disease Control and Prevention(CDC).
CDC vaccination schedule
Age
2 months One dose
4 months One dose
6 to 18 months One dose
4 to 6 years Booster dose

Polio vaccine prices for children
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On rare occasions these shots can cause mild or severe allergic reactions, such as:
breathing problems
high fever
dizziness
hives
swelling of throat
rapid heart rate
Adults in the United States arent at high risk for contracting polio. The greatest risk is when traveling to an area where polio
is still common. Make sure to get a series of shots before you travel.
Polio vaccinations around the world
Overall, cases of polio have dropped by 99 percent. Only 74 cases were reported in 2015.
Polio still persists in Afghanistan, Pakistan, and Nigeria.
From the history of polio to now
Polio is a highly contagious virus that can result in spinal cord and brainstem paralysis. It most commonly affects children
under 5 years old. Cases of polio peaked in the United States in the 1952 with 57,623 reported cases. Since the Polio
Vaccination Assistance Act, the United States has been polio-free since 1979.
While many other countries are also certified polio-free, the virus is still active in countries that havent started immunization
campaigns. According to WHO, even one confirmed case of polio puts children in all countries at risk.
Afghanistan is set to start its immunization campaign for early October and November of 2016. National and Subnational
Immunization Days are planned and ongoing for countries in West Africa. You can stay up to date with case breakdowns
on The Global Polio Eradication Initiatives website.
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Celiac Disease (Gluten Intolerance)
What Is Celiac Disease?
Celiac disease is a digestive disorder caused by an abnormal immune reaction to gluten. Celiac disease is also known as:
sprue
nontropical sprue
gluten intolerance
gluten-sensitive enteropathy
Gluten is a protein found in foods made with wheat, barley, rye, and triticale. It is also found in oats that have been made in
processing plants that handle other grains. Gluten can even be found in some medicines, vitamins, and lipsticks. Gluten
intolerance, also known as gluten sensitivity, is characterized by the body's inability to digest or break down gluten. Some
people with gluten intolerance have a mild sensitivity to gluten, while others have full-blown celiac disease.
In celiac disease, the immune response to gluten creates toxins that destroy the villi. Villi are tiny finger-like protrusions
inside the small intestines. When the villi become damaged, the body is unable to absorb nutrients from food. This can lead
to malnutrition and other serious health complications, including permanent intestinal damage.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 1 in 141 Americans has celiac
disease. People with celiac disease need to eliminate all forms of gluten from their diet. This includes most bread products,
baked goods, beer, and foods where gluten may be used as a stabilizing ingredient.
What Are the Symptoms of Celiac Disease?

Celiac disease symptoms usually involve the intestines and digestive system, but they can also affect other parts of the
body. Children and adults tend to have a different set of symptoms.
Celiac Disease Symptoms in Children
Children with celiac disease can feel tired and irritable. They may also be smaller than normal and have delayed puberty.
Other common symptoms include:
weight loss
vomiting
abdominal bloating
abdominal pain
persistent diarrhea or constipation
pale, fatty, foul-smelling stools
Celiac Disease Symptoms in Adults
Adults with celiac disease may experience digestive symptoms. In most cases, however, symptoms also affect other areas
of the body. These symptoms may include:
iron-deficiency anemia
joint pain and stiffness
weak, brittle bones
fatigue
seizures
skin disorders
numbness and tingling in the hands and feet
tooth discoloration or loss of enamel
pale sores inside the mouth
irregular menstrual periods
infertility and miscarriage
Dermatitis herpetiformis (DH) is another common symptom of celiac disease. DH is an intensely itchy skin rash made up of
bumps and blisters. It may develop on the elbows, buttocks, and knees. DH affects approximately 15 to 25 percent of
people with celiac disease. Those who do experience DH usually dont have digestive symptoms.
Its important to note that symptoms can vary from person to person depending on various factors, including:
the length of time someone was breast-fed as an infant
the age someone started eating gluten
the amount of gluten someone eats
the severity of intestinal damage
Some people with celiac disease have no symptoms. However, they may still develop long-term complications as a result of
their disease.
Page 103 of 105

Schedule an appointment with your doctor right away if you suspect that you or your child has celiac disease. When
diagnosis and treatment are delayed, complications are more likely to occur.
Who Is at Risk for Celiac Disease?

Celiac disease runs in families. According to the University of Chicago Medical Center, people have a 1 in 22 chance of
developing celiac disease if their parent or sibling has the condition.
People who have other autoimmune diseases and certain genetic disorders are also more likely to have celiac disease.
Some conditions associated with celiac disease include:
lupus
rheumatoid arthritis
type 1 diabetes
thyroid disease
autoimmune liver disease
Addisons disease
Sjogrens syndrome
Down syndrome
Turner syndrome
lactose intolerance
intestinal cancer
intestinal lymphoma
How Is Celiac Disease Diagnosed?

Diagnosis begins with a physical examination and a medical history.
Doctors will also perform various tests to help confirm a diagnosis. People with celiac disease often have high levels of
antiendomysium (EMA) and anti-tissue transglutaminase (tTGA) antibodies. These can be detected with blood tests. Tests
are most reliable when theyre performed while gluten is still in the diet.
Common blood tests include:
complete blood count (CBC)
liver function tests
cholesterol test
alkaline phosphatase level test
serum albumin test
In people with DH, a skin biopsy can also help doctors diagnose celiac disease. During a skin biopsy, the doctor will remove
tiny pieces of skin tissue for examination with a microscope. If the skin biopsy and blood test results indicate celiac disease,
an internal biopsy may not be necessary.
In cases where blood test or skin biopsy results are inconclusive, an upper endoscopy can be used to test for celiac
disease. During an upper endoscopy, a thin tube called an endoscope is threaded through the mouth and down into the
small intestines. A small camera attached to the endoscope allows the doctor to examine the intestines and to check for
damage to the villi. The doctor can also perform an intestinal biopsy, which involves the removal of a tissue sample from the
intestines for analysis.
How Is Celiac Disease Treated?

The only way to treat celiac disease is to permanently remove gluten from your diet. This allows the intestinal villi to heal
and to begin absorbing nutrients properly. Your doctor will teach you how to avoid gluten while following a nutritious and
healthy diet. They will also give you instructions on how to read food and product labels so you can identify any ingredients
that contain gluten.
Symptoms can improve within days of removing gluten from the diet. However, you shouldnt stop eating gluten until a
diagnosis is made. Removing gluten prematurely may interfere with test results and lead to an inaccurate diagnosis.
Food Precautions for People with Celiac Disease
Maintaining a gluten-free diet isnt easy. Fortunately, many companies are now making gluten-free products, which can be
found at various grocery stores and specialty food stores. The labels on these products will say gluten-free.
If you have celiac disease, it is important to know which foods are safe. Here is a series of food guidelines that can help you
determine what to eat and what to avoid.
Avoid the Following Ingredients:
wheat
Page 104 of 105

spelt
rye
barley
triticale
bulgur
durum
farina
graham flour
semolina
Gluten-Free Grains and Starches:
buckwheat
corn
amaranth
arrowroot
cornmeal
flour made from rice, soy, corn, potatoes, or beans
pure corn tortillas
quinoa
rice
tapioca
Healthy, Gluten-Free Foods:
fresh meats, fish, and poultry that havent been breaded, coated, or marinated
fruit
most dairy products
starchy vegetables like peas, potatoes, including sweet potatoes, and corn
rice, beans, and lentils
vegetables
wine, distilled liquors, ciders, and spirits
Avoid Following Unless the Label Says Gluten-Free:
beer
bread
cakes and pies
candy
cereals
cookies
crackers
croutons
gravies
imitation meats or seafood
oats
pasta
processed lunch meats, sausages, and hot dogs
salad dressings
sauces (includes soy sauce)
self-basting poultry
soups
Your symptoms should improve within days to weeks of making these dietary adjustments. In children, the intestine usually
heals in three to six months. Intestinal healing may take several years in adults. Once the intestine completely heals, the
body will be able to absorb nutrients properly.
Page 105 of 105

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Shortness of Breath After Eating

6 Common Causes of Shortness of Breath After Eating

1. Eating Too Much or Too Quickly

3. Problems with Your Lungs or Airways

4. Gastroesophageal Reflux Disease

It turns out the answer to that question is pretty simple.

The Breath Is Both Physiological And Experiential

The Difference Between Air And Breath

Anatomy Of The Diaphragm

The Diaphragm Contracts On Inhale And Relaxes On Exhale

The Movement Of The Diaphragm

Chronic Obstructive Pulmonary Disease (COPD)

Congestive Heart Failure (CHF)

Irritable Bowel Syndrome (IBS)

2. What are the symptoms of COPD?

3. What causes COPD?

5. Treatment for COPD

6. Medication for COPD

7. Diet recommendations for people with COPD

8. Living with COPD

9. What are the stages of COPD?

10. Is there a connection between COPD and lung cancer?

11. COPD statistics

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