Treating Celiac Disease: What Are My Options?

The only treatment for celiac disease is to follow a gluten-free diet. When a person is first diagnosed with celiac disease, the doctor usually will ask the person to work with a dietitian on a gluten-free diet plan. A dietitian is a health care professional who specializes in food and nutrition. Someone with celiac disease can learn from a dietitian how to read ingredient lists and identify foods that contain gluten in order to make informed decisions at the grocery store and when eating out.

Celiac disease is unrelated to other possible gastrointestinal conditions such as gastroesophageal reflux disease. For most people suffering from celiac disease, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvements begin within days of starting the diet. The small intestine is usually completely healed in 3 to 6 months in children and younger adults and within 2 years for older adults. Completely healed means a person now has villi that can absorb nutrients from food into the bloodstream.

In order to stay well, people with celiac disease must avoid gluten for the rest of their lives. Eating any gluten, no matter how small an amount, can damage the small intestine. The damage will occur in anyone with the disease, including people without noticeable symptoms. Depending on a person's age at diagnosis, some problems will not improve, such as delayed growth, tooth discoloration, and the presence of colon polyps, if any.

Some people with celiac disease show no improvement on the gluten-free diet. The condition is called unresponsive celiac disease. The most common reason for poor response is that small amounts of gluten are still present in the diet. Advice from a dietitian who is skilled in educating patients about the gluten-free diet is essential to achieve best results.

Rarely, the intestinal injury will continue despite a strictly gluten-free diet. People in this situation have severely damaged intestines that cannot heal. Because their intestines are not absorbing enough nutrients, they may need to directly receive nutrients into their bloodstream through a vein (intravenously). People with this condition may need to be evaluated for complications of the disease. Researchers are now evaluating drug treatments for unresponsive celiac disease. For additional information on treating celiac disease and colon cancer prevention, please contact your local gastrointestinal specialists.

(Bukisa ID #108131)

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How to Know if Parathyroid Disease is Causing Your Osteoporosis

The parathyroid glands control the transfer of calcium between your bones and your blood. When you have too much calcium in your bones, the parathyroid glands send parathyroid hormone [PTH]) through your endocrine system causing the transfer of calcium to your bloodstream (which is then filtered by the kidneys and eliminated through your urine). When there is too much calcium in the blood, normally functioning parathyroid glands cause calcium to be transferred from the blood to your bones. It follows, then, that normal parathyroid gland hormone levels and blood calcium levels should move in an inverse relationship to each other.

The diagnosis of parathyroid disease can be made with relative ease in most situations. A blood test that measures calcium and PTH levels will result is high levels of both calcium and PTH. However, it is extremely rare that primary care physicians will order a test of PTH levels, especially if the calcium level is only "slightly" high. The typical primary care physician might request a second calcium test to determine whether the first value was the result of a lab error or to confirm that the calcium level is high.

In many situations, the calcium level the second time will be high normal or slightly elevated, leaving the physician probably to suggest re-testing in six months. Had the physician ordered a PTH level in addition to a second test of the calcium level, the PTH level would reveal normally functioning parathyroid glands (a low PTH score) or abnormally functioning parathyroid glands (a high PTH score). A fluctuating calcium level or a continued high level of blood calcium, combined with a high PTH level, should suggest a referral to an endocrinologist or an appropriately trained surgeon.

The abnormal loss of calcium from the bones is called osteoporosis. Aging, lack of estrogen in women over 50, and parathyroid disease are the three causes of osteoporosis. Osteoporosis is not a necessary result of aging. It is a likely result of lack of estrogen in women over 50. It will result from untreated parathyroid disease. While science has developed treatments for osteoporosis, there is no treatment for osteoporosis where the cause is hypepararthyroidism.

The treatment for hyperparathyroidism, the condition of both high PTH and high calcium, is surgery. Using various techniques, the surgeon can find the likely single offending parathyroid gland and remove it. Most surgeons use what is called MIRP, Minimally Invasive Radioguided Parathyroid surgery. Some surgeons perform this surgery under local anesthesia, while some still use general anesthesia. In either event, the surgeon should take blood calcium levels during the procedure to tell if she removed the correct parathyroid gland. (If so, the calcium level will drop dramatically. If not, there are probably other parathyroid glands that need to be removed.)

The vast majority of parathyroid surgeries are successful. This means that your osteoporosis, if caused by an abnormally functioning parathyroid gland, should eventually clear up.

(Bukisa ID #62618)

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The deadly and rare Leukemia

In the United States, around 27,000 adults and 2000 children each year, the diagnosis of leukemia, a cancer of white blood cells (WBCs). During the exposure to radiation, benzene, and some anticancer drugs have shown that the risk of developing leukemia, and a few cases are associated with rare genetic diseases or viral infections, the cause of most leukemias is not known.

What is it?
Leukemia is a disease of the bone marrow, which occurs when an abnormal number of white blood cells begin to continually repeat. These cells do not function normally, they do not fight infection as they should, and they do not die at the same pace as other WBCs. Because they are, they inhibit the production of other normal blood cells in the bone marrow, causing anemia, bleeding and recurrent infections. Over time, the leukemic cells, through the bloodstream, where they continue to divide, forming tumors and sometimes damaging organs such as kidneys and liver. Since the spleen is responsible for filtering blood and destroying old cells, it can be enlarged and swollen with the abnormal cells, such as the liver and lymph nodes. When the cells reach the central nervous system and build in the cerebrospinal fluid, brain and spine, it can cause headaches and seizures.

The bone marrow is located in the middle of the soft body larger bones, produces raw (unripe versions) of red blood cells, platelets, and five different types of white blood cells. Most of these immature is an explosion. Most of these mature blood cells in bone marrow before they enter the bloodstream. The WBCs are created in two main categories: lymphocytes and myelocytes (including granulocytes for the granules inside the cell). Myelocytes (the neutrophils, basophils, eosinophils and monocytes) circulate in the blood, killing and digesting bacteria. Lymphocytes in the bloodstream and the lymphatic system, coordinate the immune response and produce antibodies. Leukemia arises from one of these white blood cells. It is categorized by the type of WBC, and how quickly it progresses. Although extended classification of diseases are the main types of leukemia, can be grouped as:

* Acute lymphocytic leukemia (ALL). This is a rapidly evolving disease that is characterized by a large number of immature lymphocytes. It is the most common form of leukemia in children, although they focus on children and adults (in general, adults 65 years and older).

* Chronic lymphocytic leukemia (CLL). The disease progresses slowly and is characterized by a mixture of mature and immature lymphocytes. There is a tendency in the age of 55 or 60th

* Acute myeloid (myelocytic) leukemia (AML). People of all ages, this disease is characterized by the production of large numbers of immature granulocyte-myeloid cells (immature neutrophils - the most common, monocytes, basophils, eosinophils, platelets or red blood cells), the other to replace normal cells in the bone marrow.

* Chronic myeloid (myelocytic or myeloid) leukemia (CML). Chronic myeloid leukemia is rare in children. It is a condition that the acquired begins in an immature stem cells in bone marrow, when parts of two chromosomes (9 and 22) cancel and switch places (translocation). This leads to an altered, fused gene (BCR / ABL) on chromosome 22, a protein called tyrosine kinase, cell growth regulation. This leads to an overproduction of granulocytic white blood cells, which many of the BCR / OJ translocation, and the presence of mature and immature cells in the bloodstream.

(Bukisa ID #41027)

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1 in a Million- Rare Disease

1 in a Million- Rare Disease

Rare means unusually good or excellent. It could also mean infrequently encountered or scarce. Diamonds are rare. But when the adjective is used to qualify a disease, it is hardly good news. Recently, Michael Jackson was reported to be suffering from a rare genetic disease called Alpha-1 antitrypsin deficiency. The condition is just one among the 8,000 or so known rare disease worldwide.

Rare diseases are also called orphan diseases, characterized by a low prevalence in the general population. Most of these conditions are chronic, progressive, debilitating and often, life -threatening. Yet, information is scarce and research insufficient. Delay in diagnosis, misdiagnosis, psychological burden and lack of support groups make orphan diseases a mammoth medical challenge.

Acknowledging this challenge for the first time, European Organization for Rare Diseases (EURORDIS) and National Alliances announced February 29, 2008, as the first European Rare Disease Day. And every non-leap year the day will be observed on February 28. We don't even have a medical definition for the term. In the common parlance, doctors refer to them as diseases that appear 'once in a blue moon.' In the United States, a rare disease occurs in less than 2, 00,000 individuals, while in the European Union less than 5 per 10,000 individuals suffer from a rare condition. Few rare of the rarest are mentioned below.

ALPHA-1 ANTITRYPSIN DEFICIENCY (Michael Jackson's ailment)

It is an inherited disorder that can cause lung disease in adults and children. It also causes a skin condition known as panniculistis which hardens the skin and causes painful lumps or patches. Symptoms usually include shortness of breath after activity, weight loss, recurring respiratory infections, fatigue, rapid heartbeat and vision abnormalities. Antitrypsin deficiency is caused by mutations in the SERPINA1 gene-the one that provides instructions for making a protein called alpha-1 antitrypsin. Replacement therapy with the missing protein is available. But its effectiveness has not yet been established. Treatment options include bronchodilators, antibiotics and lung transplantation.

MUTIPLE ENDOCRINE NEOPLASIA TYPE 2B (MEN 2B)

Those who suffer from this subtype of genetic disease invariably develop cancer in the thyroid or the adrenal gland. Physician and amateur historian John Sotos believed that Abraham Lincoln had MEN 2B. Droopy eyelids with thickened edges and bumpy upper lips; enlarged colons that bulge and gurgle audibly are a few symptoms. Some manifestations are neuromas, lumps of nerve tissue, tongue, lips and eyelids. These growths also occur in the intestines and can cause constipation or diarrhea. In about half the cases, patients inherit the disease from a parent. Though there is no known cure, surgical excision of identified tumors is considered to be an option.

MARFAN SYNDROME (Michael Phelps's condition)

This is a connective tissue disorder that involves the eyes, skeleton, heart and aorta. It is a rare disease with an incidence of 2-3 per 10,000. It is characterized by long arms, legs and fingers, loose joints and weakness of the aorta. Skeletal involvement leads to tall stature, joint hyper-mobility, chest and spine deformities. Nervous system involvement may be manifested with spinal problems, attention deficit disorder and hyperactivity. One only needs one copy of changed gene in order to have the disorder. There's no cure as yet. But a range of treatments can minimize and prevent further complications.

FRONTOTEMPORAL DEMENTIA (FTD)

This is a progressive and irreversible disorder, also known as Pick's Disease. Some of its symptoms are: behavioral changes, cognitive decline and difficulty in speaking. Some patients even develop impulsive or inappropriate behavior like blatant shoplifting. Many cases go misdiagnosed for years. Most cases are not inherited and the disease appears to be caused by an abnormal form of protein deposited in the brain cells. Some victims are as young as 20, but the average age of onset is 54. There's no treatment yet to stop or reverse the underlying brain deterioration. Therapy may, at best, offer symptomatic relief.

LONG QT SYNDROME (LQTS)

A heart rhythm disorder which causes fast, chaotic heartbeats and, in some cases, even sudden death. It typically affects children. It may be wrongly diagnosed as epilepsy or other neurological disorders. The right diagnosis can be made with an electrocardiogram (ECG). Ten genes have been identified as the cause. In addition more than 50 medications may cause Long QT syndrome. Conditions like congenital heart defects also may be a cause. Medications (beta blockers) may be used to treat the syndrome. One may also need an implantable device to control the heart's rhythm, along with lifestyle changes.

WINDSWEPT DEFORMITY

A rare knee disorder in which one knee is deformed outwards, while the other one is turned inwards. The deformity is commonly seen in children with rickets but it is very rare in adults. Only 24 cases have been reported worldwide. You can see 45 percent angulations in both knees, unlike rickets where the deformity is only in one knee. Typically, it affects children up to the age of seven or eight years. The child is born with knock knees, though congenital problems in orthopedics are extremely rare. There is little one can do by the way of medication. Bilateral knee replacement surgery is only option.

FABRY DISEASE

It is a rare hereditary disorder, which mostly affects men. Body pain, impaired sweating, exercise intolerance, skin rashes, gastro-intestinal problems, heart problems, kidney problems and nervous system problems are some of the symptoms. When people inherit the abnormal gene that causes Fabry disease, their bodies cannot produce enough alpha-galactosidase A or alpha-GAL an enzyme needed to clear certain cells in the body of a fatty substance called globotriaosylceramide or GL-3. Enzyme replacement therapy (ERT) is currently availed. Medications and lifestyle approaches for relief are advised.

KYPHOSIS

Increase in angle of curvature in the vertebrae in the backward direction leading to a hunchback deformity. The backward angulation not only results in pain and grotesque cosmetic deformity, but can also cause pressure on the spinal cord. It can also cause progressive weakness in the legs and loss of bowel and bladder control (paraplegia). Deformities above a certain angle need surgical management.

CRIGLER-NAJJAR SYNDROME

It is a rare disorder that affects the metabolism of billirubin- a chemical formed from the breakdown of blood. It results in an inherited form of non-hemolytic jaundice, often leading to brain damage in infants. An individual has to inherit two copies of the defective gene, one from each parent, in order to develop this syndrome. Symptoms include low muscle tone (hypotonia), deafness and lethargy; death or permanent brain damage may also happen. Treatment usually involves plasma exchange transfusion. Long-term phototherapy is also an option. But, as age advances, the efficacy of phototherapy declines. A definitive treatment is Partial Auxiliary Orthotopic Liver Transplantation (PAOLT).

(Bukisa ID #39956)

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Is Depression A Real Medical Condition?

In past generations of the medical community, the thoughts and views of depression were that of a temporary condition that passed with time and medication. Individuals with lingering long-term symptoms were considered mentally ill with little hope of recovery to a normal and productive life, and were treated as "broken people". With further study into the understanding of depressive states, it is generally now universally accepted within modern medicine that depression is a true medical condition, and it is treated with the respect deserving of any other debilitating illness. Due to advancements in mental health therapies and medications, in most instances individuals suffering the effects of depression can return to a normal and productive life after diagnosis and abbreviated hospitalizations.

Depression is very much a real medical condition, in that many instances of depressed behavior are attributable to a chemical imbalance in the brain. With pharmaceutical intervention, the depressed individual is enabled to have near perfect brain function, although the root of the depressive episode may have underlying psychological origins requiring therapy. In any instance, the goal of the health care provider is to return the patient to the community armed with the tools and coping skills to overcome future depressive episodes with a minimum of medical assistance. Only in the most severe cases are patients suffering from depression hospitalized for long durations or heavily medicated.

The medical issues associated with depression can be devastating and crippling in nature, ranging from eating disorders to insomnia, and from social and compulsive disorders to suicidal acts and other self-injuring behaviors. Poor diet and nutrition attributed to bouts of depression can result in any number of serious health issues, as a depressed individual's general apathy affects every aspect of daily life. Many individuals battling depression also have issues with drugs and alcohol, and the impact of addiction only magnifies the frequency and depth of depressive episodes. Personal relationships erode, family units disintegrate, and the support system of the depressed person disappears as they slide further into the darkness that disallows normalcy.

Those who question the validity of depression as a real medical condition most likely require an informal education on the destructive nature of the illness, and how an otherwise healthy and intelligent person can be severely handicapped by a very real health issue.

(Bukisa ID #124916)

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