Gastritis is an inflammation of the membrane which lines the stomach and can be both acute or chronic.
The causes of acute gastritis include infections, most commonly viral but also bacterial or parasitic (termed gastroenteritis); drugs specially aspirin and other anti-inflammatory agents; swallowing corrosive acids or alkalis; heavy drinking; unintentionally consumption of a variety of poisonous mushrooms; allergic responses to certain foods; and stress-induce gastritis occurring in cases of severe burns, multiple injuries, or major surgical operations.
Chronic gastritis may be due to a variety of poorly understood causes, including certain infections, pernicious anemia, and the heavy use of tobacco and alcohol.
Acute gastritis typically causes an uncomfortable feeling in the stomach, distension of the abdomen, headache, nausea, a coated tongue, and a bad taste in the mouth. Severe cases may include pain an tenderness in the upper abdomen, vomiting, fever, and sometimes bleeding from the stomach or black, tarry stools,
The symptoms of chronic gastritis are similar to those of acute gastritis, with possible addition of discomfort in the upper abdomen after meals, tenderness over the stomach, and a general feeling of debility.
What you can do. During the acute stage, abstain from food for one or two days. Repeated doses of a liquid, nonabsorbable antacid may provide some relief. Avoid dehydration (especially in cases of vomiting and diarrhea) by taking sips of water every ten to fifteen minutes or by sucking ice. Applying heat over the abdomen with fomentations or a heating pad may relieve the discomfort. When tolerated, take small amounts of food, with a gradual return to a normal diet. When the gastritis persist or hemorrhage occurs, or when a corrosive poison has been swallowed (after instituting emergency first aid), see your physician immediately.
For chronic gastritis you should review your habits of eating and drinking and determine to correct unhealthful ones. Eating less, eating at regular times (no in-between snacking), avoiding foods and drinks which aggravate the condition, and discontinuing alcohol and tobacco will be beneficial. Avoid factors which cause worry, anger, and other emotional upsets.
What your physician can do. He can help determine the underlying cause and then institute appropriate therapy. If drug appears responsible, he can change or discontinue the agent temporarily.
When vomiting and diarrhea continue, he will suggest medication to remedy the situation. In case of dehydration, intravenous fluids will help, as will a transfusion if blood loss has been extensive.
Cancer of the lung
In 1986, cancer of the lung, or bronchial carcinoma, became the most common cancer of both men and women in the United States, and now causes more deaths in both groups than any other cancer. While a number of other types of cancer can occur in the lungs, bronchial carcinoma is the most frequent and, with rare exception, is due to inhaling tobacco smoke.
That tobacco smoke causes lung cancer goes without question, except in the minds of the tobacco manufacturers. Many factors influence the incidence of smoking related cancer.
Cancer types: The majority of lung cancers are either of the squamous cell (flat, scaly) variety or adenocarcinomas (gland cell). Squamous cell cancers go through a precancerous phase, and their cells may be detected in the sputum. They do not spread to distant parts of the body as readily as do the adenocarcinomas.
Symptoms: The most common symptoms of the lung cancer is cough, but since most smokers have a so-called "smoker's cough" and a chronic bronchitis with sputum, the problem often goes unnoticed until the cough has become quite severe, or the sputum is tinged with blood. Frequently there is shortness of breath, and pain in the chest that increases when inhaling deeply.
Often the first recognition of a lung cancer is the discovery of a cancer at some distant site where it has spread. Common sites to which lung cancer may travel (metastasize) are to the other lung, the brain, bones, and liver. A cancer in the brain may cause headache, mental confusion, convulsions, or a stroke. If the cancer lodges in a bone there is often deep pain, swelling, and often a fracture, or compression of the bone if it is in the vertebral column. Liver involvement is associated with indigestion and jaundice.
General symptoms often include loss of appetite, loss of weight, excessive tiredness, a low grade continual fever, and progressive weakness.
The prognosis for cancer of the lung is not encouraging since so often the growth has already spread beyond the reach of the surgeon's knife. A light smoker is ten times more likely to develop a lung cancer than one who does not smoke, while a heavy smoker is twenty five times more liable.
What you can do. You should see your physician at the earliest possible occasion if you notice any of the above sign or symptoms. If you are a smoker, you should stop immediately. If you decide to continue to smoke, and are concerned about getting lung cancer, you should periodically have a pap smear of your sputum, an X-ray of your chest, and be checked by your physician every six months.
What your physician can do. A number of diagnostic procedures are available. Chest X-rays and the examination of sputum are usually effective. Your doctor may call for a bronchoscopic evaluation, during which washings, brushings, and a biopsy may be obtain. An ultrasonograph or CT scan may be desirable. A needle biopsy or aspiration is helpful if the lesion is located in the outer parts of lung.
The treatment is usually surgical removal of the involved area of the lung or of the entire lung, together with chemotherapy and radiation therapy. The five-year survival rate is about 10 percent.
That tobacco smoke causes lung cancer goes without question, except in the minds of the tobacco manufacturers. Many factors influence the incidence of smoking related cancer.
Cancer types: The majority of lung cancers are either of the squamous cell (flat, scaly) variety or adenocarcinomas (gland cell). Squamous cell cancers go through a precancerous phase, and their cells may be detected in the sputum. They do not spread to distant parts of the body as readily as do the adenocarcinomas.
Symptoms: The most common symptoms of the lung cancer is cough, but since most smokers have a so-called "smoker's cough" and a chronic bronchitis with sputum, the problem often goes unnoticed until the cough has become quite severe, or the sputum is tinged with blood. Frequently there is shortness of breath, and pain in the chest that increases when inhaling deeply.
Often the first recognition of a lung cancer is the discovery of a cancer at some distant site where it has spread. Common sites to which lung cancer may travel (metastasize) are to the other lung, the brain, bones, and liver. A cancer in the brain may cause headache, mental confusion, convulsions, or a stroke. If the cancer lodges in a bone there is often deep pain, swelling, and often a fracture, or compression of the bone if it is in the vertebral column. Liver involvement is associated with indigestion and jaundice.
General symptoms often include loss of appetite, loss of weight, excessive tiredness, a low grade continual fever, and progressive weakness.
The prognosis for cancer of the lung is not encouraging since so often the growth has already spread beyond the reach of the surgeon's knife. A light smoker is ten times more likely to develop a lung cancer than one who does not smoke, while a heavy smoker is twenty five times more liable.
What you can do. You should see your physician at the earliest possible occasion if you notice any of the above sign or symptoms. If you are a smoker, you should stop immediately. If you decide to continue to smoke, and are concerned about getting lung cancer, you should periodically have a pap smear of your sputum, an X-ray of your chest, and be checked by your physician every six months.
What your physician can do. A number of diagnostic procedures are available. Chest X-rays and the examination of sputum are usually effective. Your doctor may call for a bronchoscopic evaluation, during which washings, brushings, and a biopsy may be obtain. An ultrasonograph or CT scan may be desirable. A needle biopsy or aspiration is helpful if the lesion is located in the outer parts of lung.
The treatment is usually surgical removal of the involved area of the lung or of the entire lung, together with chemotherapy and radiation therapy. The five-year survival rate is about 10 percent.
Osteoporosis
In osteoporosis, a condition in which the bone substance or matrix is depleted, the bones become thin and weakened. Normally a balance exist between the minerals entering and leaving the bones. When loss is greater than retention, demineralization occurs and osteoporosis develops.
Osteoporosis occurs in certain types of malnutrition, vitamin C deficiency, calcium deficiency, hyperthyroidism, diabetes, and conditions of excess adrenal cortical hormones. Causitive factors include lack of estrogen, especially in women after menopause, cortisone therapy, aging, and lack of exercise.
Osteoporosis generally produces no symptoms. Height may gradually decrease as the vertebrae weaken and compress, and the individual becomes increasingly stooped. Back ache is also fairly common, and pain become severe when a compression fracture occurs in a vertebrae as it collapses, or when a hip or arm fractures.
What you can do. Regular exercise and a nutritious diet adequate in calcium and vitamin C and low in protein (high protein intake increases calcium loss) provide both prevention and cure. Sunshine will provide vitamin D (take a supplement if sunlight is not available), which will aid in calcium absorption. Increasing calcium intake alone will not reverse the problem. Many postmenopausal women do not get enough calcium, and so may need a calcium supplement.
What your physician can do. He will try to find and treat any underlying cause, and by means of laboratory test and x-rays determine the extent of your osteoporosis. If you are a woman past menopause, he may recommend estrogen therapy.
Osteoporosis occurs in certain types of malnutrition, vitamin C deficiency, calcium deficiency, hyperthyroidism, diabetes, and conditions of excess adrenal cortical hormones. Causitive factors include lack of estrogen, especially in women after menopause, cortisone therapy, aging, and lack of exercise.
Osteoporosis generally produces no symptoms. Height may gradually decrease as the vertebrae weaken and compress, and the individual becomes increasingly stooped. Back ache is also fairly common, and pain become severe when a compression fracture occurs in a vertebrae as it collapses, or when a hip or arm fractures.
What you can do. Regular exercise and a nutritious diet adequate in calcium and vitamin C and low in protein (high protein intake increases calcium loss) provide both prevention and cure. Sunshine will provide vitamin D (take a supplement if sunlight is not available), which will aid in calcium absorption. Increasing calcium intake alone will not reverse the problem. Many postmenopausal women do not get enough calcium, and so may need a calcium supplement.
What your physician can do. He will try to find and treat any underlying cause, and by means of laboratory test and x-rays determine the extent of your osteoporosis. If you are a woman past menopause, he may recommend estrogen therapy.
Curvatures of the spine
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| Normal and abnormal postures. |
In kyphosis the person becomes round-shouldered with the chest sunken in. Lordosis in the low back causes the buttocks to protrude backward and the abdomen forward. Increase stress on the muscles result in lower back pain.
Scoliosis and the other abnormal curvatures may first appear in early childhood, but generally become obvious during adolescence. They occur more often in girls. If scoliosis is not corrected, it progressively becomes worse during growth. The rib cage becomes distorted, and the vertebrae tend to rotate, at times causing difficulty in breathing and frequent chest infections.
The tendency toward scoliosis may be inherited, or it may be aggravate by weakened muscles, by one leg being shorter than the other, causing a pelvic tilt, or by a habit of standing and sitting poorly. However, in most cases the cause is not known.
What you can do. As soon as you observe what appears to be an abnormal curvature, consult with your physician. Postural exercises may improve kyphosis but not scoliosis.
What your physician can do. He can determine whether you need a brace on how long to wear it. In severe and advanced cases he may advise surgery.
Goiter
Nontoxic goiter. In this condition the thyroid gland enlarges in an effort to produce more thyroxine. Because the hormone is in short supply, the pituitary glands stimulates the thyroid to compensate for the deficiency. Factors which provoke this response a shortage of iodine (a constituent of thyroxine) in the food or water; an overuse of thyroid-depressing drugs; and Hashimoto's disease, in which the glandular tissue of the thyroid is destroyed.
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| Thyrotoxicosis (Graves' disease). The eyes appear to bulge and are abnormally prominent. |
A number of forms of overactive thyroid exist; however, the most common problem is overproduction of thyroxine, in spite of a suppression of thyroid-stimulating hormone by the pituitary. Excess thyroxine speeds up all the chemical ( metabolic) activities of the body, affecting both physical and mental functions.
Graves' disease or thyrotoxicosis occurs eight times more often in women than in men, and is thought to be disturbance in the body's immune system. Less common causes include tumors of the thyroid, pituitary, and placenta. The usual symptoms consist of nervousness, intolerance to heat, rapid heartbeat, weight loss despite increase appetite, excessive thirst, tiredness, difficult breathing, weakness of the muscles, fine tremor of the hands, frequent urination, and diarrhea.
The thyroid usually enlarges (goiter), and in many cases, the eyes have a ''staring expression'' and appear to bulge (exophthalmic goiter). If the condition remains untreated, the heart may fail through overactivity.
Toxic nodular goiter usually occurs as a late complication of non-toxic goiter and in most cases develops later in life. The symptoms are less extreme, develop more slowly, and do not include bulging of the eyes. Hearth damage may occur in neglected cases.
what your physician can do. Depending on the severity of the condition, your physician will recommend the most desirable of several methods. A radioiodine scan may help determine the extent of the problem. Antithyroid drugs are used to suppress overactive hormone production, but often the benefit is temporary. The most successful therapy is a single treatment of radioactive iodine, which concentrates in the gland and destroys overactive secreting cells. Many patients become hypothyroid and require replacement hormonal therapy.
Bunions
A bunions is a tender, painful enlargement caused by inflammation of the soft tissues (bursal sac) and bone at the outer edge of the base of the big toe. The great toe bends toward the little toe and may overlap the second toe. The skin over the protrusion rubs against the shoe and forms a callus.
Bunions usually develop at the same time on both feet. Hereditary factors include a wide foot, muscle imbalance and relaxed ligaments. Tight-fitting, pointed, high-heeled shoes, seem to force the toes into this abnormal position. The longer the irritation continues, the greater the deformity.
Rest, foot baths, and cutting away the shoe at the side of the bunion will relieve the pain in most cases. You should wear shoes of such size and shape as to allow the great toe to assume its normal straightforward position. Placing padding between the first and second toes will help push the big toe toward its more normal position. Night splints are available commercially. In severe cases surgical repair may be the only satisfactory solution.
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| Bunions. Note how the bones of the big toe are directed toward the little toe instead of forward, as shown in the normal foot at left. |
Rest, foot baths, and cutting away the shoe at the side of the bunion will relieve the pain in most cases. You should wear shoes of such size and shape as to allow the great toe to assume its normal straightforward position. Placing padding between the first and second toes will help push the big toe toward its more normal position. Night splints are available commercially. In severe cases surgical repair may be the only satisfactory solution.
Pneumonia
Pneumonia is describes any of the acute infections of the lungs in which the lining of the air sacs is inflamed and swollen, and cells and fluid fill the air spaces, making it difficult to breath. A number of common terms describe various forms of disease. "Double pneumonia" refers to involvement in both lungs. Involvement localized to one or more lobes of the lung, is called "lobar pneumonia." A scattered or patchy infection in one or both the lungs is called "bronchopneumonia." Still another is "atypical pneumonia" caused by Mycoplasma organisms.
The inflammation can be caused by any one of a number of germs (bacteria, viruses, fungi) to which one is frequently exposed, and irritant poisonous gases. The pneumonia may be mild to severe, depending on the organism and the measure of health of the person. Predisposing factors include hearth disease. cancer, stroke, coma, other infections of the respiratory tract (common cold, influenza), inhaled foreign material, alcoholism, malnutrition, drugs given to suppress immunity, and often any debilitating or terminal illness.
The precise symptoms of pneumonia will vary with the infecting organism, and may have an abrupt or gradual onset. Those most commonly observed are cough, fever (up to 105 digress F), and shortness of breath. Others include chills, sweating. headache, nausea, vomiting, rapid, shallow breathing, chest pain, bloody sputum, and blueness of the skin (cyanosis).
Viral pneumonia, generally mild, are commonly associated with the common cold. In fact, they not infrequently pass as a severe cold. These common pneumonias account for about 75 percent of lung infections. However, influenza A virus pneumonia can be severe, and even fatal. Usually carried by droplets of moisture expelled by sneezing, this virus does not respond to antibiotic therapy.
Bacterial pneumonias -- usually more severe and dangerous -- are commonly caused by the pneumococcus. If untreated, the disease runs it course in about two weeks, ending in death in more than 30 percent of the cases and in prompt improvement (by "crisis") in the remaining 70 percent. Treatment with antibiotics (penicillin G) or sulfonamides reduces the mortality to less than 5 percent. A vaccine is now available which protects against this type of pneumonia. Other bacteria which may cause pneumonia include streptococcus, Klebsiella, Haemophilus, and, worst of all staphylococcus. They also respond to antibiotics. Complications of bacterial pneumonias include pleurisy, empyema, lung abscess, infection of the heart (pericarditis or endocarditis), and meningitis.
Mycoplasmal pneumonia most commonly appears among adolescents and young adults, It is caused by a tiny bacterium like organism, Mycoplasma. The illness starts gradually with a chest cold, dry cough, and fever, and may reach epidemic proportions in the military and in schools. It responds to antibiotics (erythromycins and tetracyclines, not penicillins). When untreated, spontaneous recovery usually occurs in about ten days. It is spread by droplets produced by the sneezing and coughing of an infected individual.
The inflammation can be caused by any one of a number of germs (bacteria, viruses, fungi) to which one is frequently exposed, and irritant poisonous gases. The pneumonia may be mild to severe, depending on the organism and the measure of health of the person. Predisposing factors include hearth disease. cancer, stroke, coma, other infections of the respiratory tract (common cold, influenza), inhaled foreign material, alcoholism, malnutrition, drugs given to suppress immunity, and often any debilitating or terminal illness.
The precise symptoms of pneumonia will vary with the infecting organism, and may have an abrupt or gradual onset. Those most commonly observed are cough, fever (up to 105 digress F), and shortness of breath. Others include chills, sweating. headache, nausea, vomiting, rapid, shallow breathing, chest pain, bloody sputum, and blueness of the skin (cyanosis).
Viral pneumonia, generally mild, are commonly associated with the common cold. In fact, they not infrequently pass as a severe cold. These common pneumonias account for about 75 percent of lung infections. However, influenza A virus pneumonia can be severe, and even fatal. Usually carried by droplets of moisture expelled by sneezing, this virus does not respond to antibiotic therapy.
Bacterial pneumonias -- usually more severe and dangerous -- are commonly caused by the pneumococcus. If untreated, the disease runs it course in about two weeks, ending in death in more than 30 percent of the cases and in prompt improvement (by "crisis") in the remaining 70 percent. Treatment with antibiotics (penicillin G) or sulfonamides reduces the mortality to less than 5 percent. A vaccine is now available which protects against this type of pneumonia. Other bacteria which may cause pneumonia include streptococcus, Klebsiella, Haemophilus, and, worst of all staphylococcus. They also respond to antibiotics. Complications of bacterial pneumonias include pleurisy, empyema, lung abscess, infection of the heart (pericarditis or endocarditis), and meningitis.
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| A. Bronchopneumonia with pussy exudate in the terminal bronchiole. B. Lobar pneumonia showing air sacs filled with fibrinous exudate. |
Legionnaires' pneumonia or Legionnaires' disease, first observe in epidemic proportions in 1976 in Philadelphia during an American Legion convention, is caused by a bacterium named Legionella pneumoplilia. Unlike the typical persons-to-person transmittal, these bacteria carried by the air, in some cases by a contaminated air-conditioning system. The symptoms parallel those of a severe pneumonia. The disease progresses rapidly, and the sufferer should be hospitalized and treated with an appropriate antibiotic, A possible complication is kidney failure.
What you can do. Great care should be taken in attempting to treat cases of pneumonia at home. Infants and the elderly (excepts as a terminal event) are best cared for in a hospital. After a careful evaluation of the condition, your physician will determine what is best. Under his direction, you can carry out certain procedures if you or a family member are treated in your home, or after returning home from the hospital. These are discussed bellow.
What your physician can do. Your physician will probably hospitalized you and then determine the cause and extent of your problem. Laboratory examination of your sputum, and possibly blood, will reveal the organism involved. X-rays of the lungs will also aid in determining the type of pneumonia. This will direct in the selection of the most effective medication.
Bed rest, the administration of fluids to avoid dehydration, and oxygen, if necessary, will be supportive. The inhaling of steam from a vaporizer or a kettle of water (be careful not to get burned) will open the air passages and help from coughing up mucus. Hydrotherapy treatments in the form of a hot foot bath along with fomentations to the chest and back, repeated twice and given three or four times a day, will be helpful until the infection subsides. And a program of exercise to tolerance, adequate rest and sleep, and a good nutritious diet will speed recovery.
Sore Throat (pharyngitis)
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| Canker sores in the mouth and on the tongue. |
The sore throat may be caused by a virus or any one of a number of bacteria, usually streptococcus or staphylococcus. Sore throat is part of the initial illness in measles, scarlet fever, and whooping cough. It is a symptom in leukemia and infectious mononucleosis, and may accompany such diseases as tuberculosis, syphilis, and cancer. When not accompanied by infection, sore throat may be the result of smoking tobacco, drinking hard liquor, drinking excessively hot fluids, or from using concentrated mouthwashes and antiseptic gargles.
What you can do. Apply hot water heating compresses for relief . Throat lozenges may provide some relief. Apply hot fomentations to the neck for twenty minutes two or three times a day. If you have a fever, stay in bed, and, despite the discomfort, drink plenty of water and go on a liquid diet (fluid intake should be two to three quarts daily). If the soreness gets worse or persists for more than two or three days, consult your physician. If your sore throat is not due to and infection, remove the cause; for example, stop the use of tobacco or alcohol.
What your physician can do.
For an infection your physician will probably prescribe an antibiotic, especially for a streptococcal infection. If persists, tests can determine if the problem is more serious.
Canker sores (mouth ulcers, aphthous ulcers)
Canker sores are usually small red swellings or tiny blisters that occur on the membrane which lines the mouth, on the under surface of the tongue, on the gums, and on the soft palate. Occasionally numerous, they may fuse together and become large. The pain may make eating and speaking difficult.
A number of condition may initiate canker sores.These include: injury due to a jagged tooth; lowered resistance due to some illness or from fatigue; emotional stress; nutritional deficiencies of vitamin B12, folic acid, and iron; a virus infection such as herpes simplex (cold sores); or a menstrual period. Canker sores affect girls and women more than boys and men. This usually self-limiting disease appears once or twice a year and causes little inconvenience except soreness of the mouth. A mouth ulcers may indicate a more serious problem, such as leukemia or a local malignancy.
what you can do. Rinsing the mouth with warm salt water or with an antiseptic mouthwash will relieve the pain. Ointments and lozenges may also provide relief. Avoid any foods that produce discomfort, such as spicy or highly acid foods.
what your physician can do. If the ulcers do not heal within ten to fourteen days, your physician may recommend a steroid preparation or check for a more serious problem.
what you can do. Rinsing the mouth with warm salt water or with an antiseptic mouthwash will relieve the pain. Ointments and lozenges may also provide relief. Avoid any foods that produce discomfort, such as spicy or highly acid foods.
what your physician can do. If the ulcers do not heal within ten to fourteen days, your physician may recommend a steroid preparation or check for a more serious problem.
THE MONTHLY CYCLE (MENSTRUATION AND PREGNANCY)
As a girl begins to reach womanhood, her breasts begins to enlarge, and hair starts to grow in her pubic area. A year or two later she undergoes a period of rapid growth, after which she begins to menstruate. At first the intervals between menses are irregular because her ovaries are not producing mature sex cells. However, within a year or so, the time of menstruation becomes irregular.
A rhythmic pattern are called the 28-day female menstrual cycle, changes in the lining of the uterus (mucosa) and body temperature during a (more accurately the female sexual cycle) continues throughout the normal reproductive years, and is regulated by rhythmic changes in the female hormones.
A rhythmic pattern are called the 28-day female menstrual cycle, changes in the lining of the uterus (mucosa) and body temperature during a (more accurately the female sexual cycle) continues throughout the normal reproductive years, and is regulated by rhythmic changes in the female hormones.
The ebb and flow of these hormones causes the changes seen in the sexual organ (ovary, uterus, breasts). While the average cycle is twenty eight days, the interval may vary from as little as twenty days to more than forty days in perfectly normal women.
Stimulated by hormones from the pituitary gland (follicle-stimulating hormone -- FSH, and luteinizing hormone--LH), a few mature follicles (up to ten) in each ovary respond, but only one ovary releases an ovum (usually alternating each month between ovaries). This process,called ovulation, occurs fourteen days after sexual (menstrual) cycle. Note the abrupt drop in body temperature at the time of ovulation.menses begins,in a woman who has a twenty-eight day cycle.
The cells lining the empty follicle rapidly increase in number and become changed to lutein cells (forming the corpus luteum) which secrete progesterone and estrogen. Under the influence of these hormones, the lining of the uterus, called the endometrium,undergoes considerable change. Blood vessels increase in number, the lining cells multiply rapidly, the endometrium doubles in thickness (becoming 4 to 6 millimeters thick), growing soggy with nutritious secretions known as "uterine milk",and takes on a velvety appearance -- all in readiness to received a fertilize ovum. When conception does not occur, the level of the ovarian hormones (estrogen and progesterone) drops suddenly. Without the encouragement of these hormones the endometrium begins to deteriorate. The underlying blood vessels narrow and soon break apart. The lining cells, denied the blood they need, disintegrate. The unfertilized ovum with much of the mucous membrane is shed, accompanied by the loss of considerable blood. Contractions of the uterus (sometimes causing painful "cramps") aid in expelling this blood and tissue through the vagina. This process is called menstruation.
Typically, five days after menstruation starts (anywhere from three to seven days is normal), blood flow ceases. A little more than 2 ounces (70 ml) of blood, cells, and tissue fluids are lost.The inside of the uterus is now completely stripped of its lining, and rebuilding of this lining begins again in anticipation of a pregnancy occurring during the next month. The enormous number of white cells present in the menstrual flow protect the uterus from possible infection.
When conception does occur, the cells of the endometrium initially act as nursemaid to the fertilized egg when its first arrives in the womb (about four days after conception). A secretion called "uterine milk"provides the rapidly growing embryo the food it needs. After three or four days, the ovum implants itself in the lining. Still later, as the demands of the growing embryo increase, the placenta develops. The placenta is an organ which act as a go- between for the mother and fetus. Oxygen and nutrients from the mother's blood pass to the blood of the fetus, while many of the waste formed by the fetus move in the opposite direction. These waste travel through the placenta into the mother's blood, to be expelled by her eliminative organs. Some of the major events in the calendar of a twenty-eight-day menstrual cycle are summarized below. The menstrual flow continues for about five days, following which the rebuilding of the uterine lining begins and continues for eleven or twelve days (proliferative phase). Then,for another eleven to twelve days, the lining cells fill with fluid to nourish the ovum (secretory phrase). Fourteen days after the start of menstruation, ovulation occurs.Twenty-six days from the start, if the ovum is not fertilized, the lining begins to disintegrate, and two days later menstruation commences again.
DISORDERS OF THE URETERS AND BLADDER ( Urinary incontenence)
Urinary incontinence is the inability to hold urine in the bladder or release it as desired. A sudden uncontrollable desire to void is called urge incontinence. Such loss of control commonly occurs during an infection in the bladder (cystitis) or urethra (urethritis). Other causes of incontinence include spinal cord injury, injury during childbirth, an enlarge prostate, and diseases such as Alzheimer's disease, and multiple sclerosis.
In the case of weakened sphincters and pelvic floor muscles, unexpected vigorous laughing, coughing, and straining (as when lifting something heavy), causes unwilling urine loss called stress incontinence.
What your physician can do. He will treat the underlying infection or disease. He may suggest that you strengthen the weak muscles by trying to hold your urine when the urge to urinate comes. Surgical repair may be necessary in some cases.
DISORDERS OF THE URETERS AND BLADDER (Ureteral stricture).
The right and left ureters carry urine from the right and left kidneys to the urinary bladder.
URETERAL STRICTURE:
Occasionally a narrowing or stricture occurs in one ureters, interfering with the normal flow of the urine. Narrowing may be the result of damage to the lining from the presence or passing of a kidney stone or from some external pressure as from an enlarging tumor. The symptom - pain in the lower back which travels to the region of the groin - may vary from a dull ache to almost intolerable pain.
What your physician can do. He may decide to periodically dilate or stretch the narrowing by passing a catheter, using a cystoscope, from the bladder up the ureter. When this method is not feasible, he may remove the kidney and ureter on the affected side, but only if the opposite ureter and kidney are functional.
URETERAL STRICTURE:
Occasionally a narrowing or stricture occurs in one ureters, interfering with the normal flow of the urine. Narrowing may be the result of damage to the lining from the presence or passing of a kidney stone or from some external pressure as from an enlarging tumor. The symptom - pain in the lower back which travels to the region of the groin - may vary from a dull ache to almost intolerable pain.
What your physician can do. He may decide to periodically dilate or stretch the narrowing by passing a catheter, using a cystoscope, from the bladder up the ureter. When this method is not feasible, he may remove the kidney and ureter on the affected side, but only if the opposite ureter and kidney are functional.
Kidney Stones (renal calculi)
Kidney stones are masses of solid material, the vast majority of which form and enlarge within the kidney pelvis, while about two percent develop within the tubules of the kidneys. The common stones are composed of calcium oxalate ,uric acid, and cystine-precipitates of chemicals normally held in solution. They occur more frequently in some families and in certain geographic areas.
Certain factors appear to trigger stones formation, including infections of the kidney; obstructions to the flow of urine due to acquired or inherited defects; metabolic/ disorders such as gout (increase in uric acid), hyperthyroidism (increase in blood calcium levels), and excessive absorption of oxalate;dietary imbalances (diets high in protein increase excretion of calcium, phosphorous, and uric acid); and not drinking enough water.
Some stones remain in the kidney for long periods without causing symptoms. Usually, however, discomfort ranges from a dull ache in the lower back to extremely severe colicky pain,which comes and goes in waves. Spasm of the ureter muscles causes the pain. As the stones moves down toward the bladder, the pain shifts to the flank, lower abdomen, and then the groin. As the stone passes into the bladder, the pain is relieved. Injury from the stone may cause blood in the urine.
The presence and the location of the stone can be determined by means of an X-rays or by X-rays using a dye which is infected into the blood and excreted in the urine (intravenous pyelogram).
What you can do. You should be under the care of your physician. However, you can do a number of things yourself. Drink large quantities of water (enough to produce 4 quarts or four liters of urine per twenty four hours).This may help to flush out a stone, keep it for enlarging, and help prevent the formation of the new stones. A low salt intake, and a diet with 30 to 40 grams of protein per day will not only reduce the workload of the kidneys, but also decrease the excretion of wastes which tend to form stones.
What your physician can do. By periodic examinations he can advice as to whether stones are growing or forming. Should you have high levels of uric acid, he may prescribe medications, together with a chance of diet, to help correct this situation. The problem of a stone which fails to pass or which blocks urine flow require treatment.
A stone low down in the ureter can be removed through the bladder.
Stones higher up can now be reached using a tube inserted in the side. If not removed the stone can be electrically fragmented and then extracted. Direct surgical removal may be necessary. However, some institutions have an ultrasonic shock wave machine (lithotriptor) which can shatter the stone by directing the shock waves from outside the body.
Some stones remain in the kidney for long periods without causing symptoms. Usually, however, discomfort ranges from a dull ache in the lower back to extremely severe colicky pain,which comes and goes in waves. Spasm of the ureter muscles causes the pain. As the stones moves down toward the bladder, the pain shifts to the flank, lower abdomen, and then the groin. As the stone passes into the bladder, the pain is relieved. Injury from the stone may cause blood in the urine.
What you can do. You should be under the care of your physician. However, you can do a number of things yourself. Drink large quantities of water (enough to produce 4 quarts or four liters of urine per twenty four hours).This may help to flush out a stone, keep it for enlarging, and help prevent the formation of the new stones. A low salt intake, and a diet with 30 to 40 grams of protein per day will not only reduce the workload of the kidneys, but also decrease the excretion of wastes which tend to form stones.
What your physician can do. By periodic examinations he can advice as to whether stones are growing or forming. Should you have high levels of uric acid, he may prescribe medications, together with a chance of diet, to help correct this situation. The problem of a stone which fails to pass or which blocks urine flow require treatment.
A stone low down in the ureter can be removed through the bladder.
Stones higher up can now be reached using a tube inserted in the side. If not removed the stone can be electrically fragmented and then extracted. Direct surgical removal may be necessary. However, some institutions have an ultrasonic shock wave machine (lithotriptor) which can shatter the stone by directing the shock waves from outside the body.
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