Health Tips - Abdominal/Gastrointestinal/OBGYN/Urinary
Age For Breast Cancer Screening Moves From 40 to 50 - In the November 17, 2009 publication Annals of Internal Medicine the US Preventive Services Task Force (USPSTF) came out against routine breast cancer screening for women under the age of 50. Women between the ages of 40 and 49 at high risk for breast cancer should talk to their doctor about the best time to start regular, screening mammography.
The USPSTF also suggests changing the screening interval from 1 year to 2, up to the age of 74. They noted that there is insufficient evidence to determine the screening benefits for women over 75.
The USPSTF recommends against teaching breast self-examination, as adequate evidence suggests that teaching self-examination does not reduce breast cancer mortality. USPSTF researchers also conclude that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination for women 40 and over.
According to the available evidence, screening with film mammography reduces breast cancer mortality, especially for women aged 50 to 74 years, with the greatest benefit seen in women aged 60 to 69.
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Appendicitis The appendix is a 3-4-inch finger-shaped pouch that is attached to the cecum (the beginning of the large intestine). The appendix is located in the lower right side of the abdomen. Appendicitis is inflammation of the appendix. Persons suffering with acute appendicitis often classically report:
- Initially central abdominal pain
- Subsequently Right lower abdominal pain
- Loss of appetite
- Occasionally, fever, diarrhoea, nausea, vomiting, urinary frequency and lethargy
Appendicitis is a medical emergency. It requires the removal of the appendix as soon as appendicitis has been diagnosed. Surgical removal is referred to as an appendectomy and is either carried out via laparotomy or laparoscopy. You can live a normal life without your appendix.
When the appendicitis is suspected the aim is to remove the appendix quickly, most people recover with no complications. Anyone can have appendicitis; however, it occurs most often between the ages of 10 and 30. If you think you may have appendicitis, it is important to see a doctor as soon as possible.
If you are not treated, your appendix could rupture. This can cause infection and even death.
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Bed Wetting (Enuresis) - Enuresis is defined as the unintentional discharge of urine during sleep twice a week for at least three months during the night or day with no underlying physiological cause. At age five 7% of boys and 3% of girls are affected. Enuresis tends to run in families.
Bedwetting can sometimes be caused by a serious medical problem such as diabetes, sickle-cell anemia, epilepsy, enlarged adenoids, snoring, urinary tract infection, severe constipation or spinal cord pathology.
Enuresis can often be controlled by instituting the following techniques:
- Reminding the child to urinate before going to bed, if he or she feels the need.
- Limiting liquid intake at least two hours before bedtime.
- A special sensor can be placed in the child's pyjamas. This sensor triggers an alarm that wakes the child at the first sign of wetness. This is considered the most effective form of treatment now available.
- Encouraging and praising the child for staying dry.
- Bladder training: having your child practice holding his or her urine for longer and longer times.
Most children eventually “grow out” of this problem without treatment.
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Belching, Bloating and Flatulence - These are embarrassing symptoms that may beset any person. There are many patients who visit their doctor complaining of “gas” or “air” as their predominant symptom. It is not unusual for the patient to demonstrate to the doctor the extent of their “belching problem”. Persons complaining of excessive belching, bloating or flatulence are advised to reduce their “gas/ air” by:
- Slowly eating or drinking
- Chewing your food properly
- Making sure you dentures fit properly
- Having your post nasal drip treated
- Stopping forced belching to relieve abdominal discomfort
- Eating fewer fatty foods because fat slows digestion
- Stopping your smoking
- (As a very last resort) reducing your intake of broccoli, cauliflower, beans/ peas, cabbage, lettuce, onions, apples, peaches, pears, chewing gum, carbonated beverages, wheat, oats, corn, potatoes and raisins
You should consult your doctor immediately if there is any concurrent weight loss, diarrhea, nausea/ vomiting, persistent heart burn or abdominal or rectal pain.
If your symptoms persist see your doctor to determine if you are lactose intolerant. Treatment options that may be considered include simethicone and activated charcoal.
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Benign Prostatic Hyperplasia (BPH) - The prostate is a walnut-sized gland that surrounds the urethra (the canal through which urine passes out of the body). As men age, this “natural” enlargement of the prostate, is called BPH. This is NOT cancer. BPH does not cause any problems before age 40. Most men over 60 have symptoms of BPH.
Tissue encasing the prostate restricts its expansion; hence, an enlarging prostate increasingly compresses the urethra. The thickened and increasing irritable bladder wall contracts a lot more readily over time, even when there is only a small amount of urine within.
Eventually the bladder looses its ability to empty completely. This is as a result of a weakening bladder and the enlarged prostate physically impeding the outflow of urine. The increasingly narrowing of the urethra results in hesitancy (difficulty in initiating urination) and a weakening stream, therefore, there is increased straining in order to empty his bladder. Ultimately the patient may stop passing urine altogether leading him to seek urgent medical attention. Men are advised to seek medical attention at the earliest symptoms of BPH – i.e. hesitancy, urinary frequency, straining, reduced stream, nocturia (passage of urine at night), etc.
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Controlling Heartburn/GERD - To control your heartburn you may have to restrict/eliminate an item if you have noticed that it brings on or worsens your symptoms – Such items include:
- Fried or fatty foods
- Chocolate
- Peppermint
- Alcohol
- Coffee (decaf too)
- Tea
- Carbonated beverages
- Ketchup and mustard
- Pepper sauce
- Vinegar
- Avoid chewing gum
- Tomato – sauce/ juice
- Citrus fruits or juices
- Aspirin, anti-inflammatory pain medications
- Decrease the size of portions at mealtimes
- Eat meals two to three hours before lying down
- Elevate the head of the bed four to six inches using blocks
- If you are overweight, lose weight
- Avoid tight clothing or control top hosiery and body shapers
- Stop smoking, as cigarettes decrease the ability of the lower esophageal sphincter muscle to work properly.
For occasional heartburn, over-the-counter medicines taken as directed can be helpful in reducing symptoms. If prolonged or frequent use of non-prescription medicines (more than directed on the product) becomes necessary your GP or a gastroenterologist should be consulted.
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Dietary Supplements Discouraged for Patients Undergoing Radiation for Prostate Cancer - In a recent issue of International Journal of Radiation Oncology*Biology*Physics a study concluded that prostate-specific dietary supplements should not be taken during radiation therapy treatments because they have been shown to increase the radiosensitivity of normal prostate cell lines, leading to normal tissue complications.
Some studies show that approximately 50% of prostate cancer patients use a herbal or dietary supplement and most do so without even informing their treating physician.
The study’s authors set out to determine if any of the 3 widely used commercial prostate-specific dietary supplements (Trinovin, Provelex and Prostate Rx) changed the radiosensitivity of normal prostate and/or androgen-positive and -negative prostate tumour cell lines.
The study’s authors found the cell growth and radiosensitivity of the malignant tumour cells were not affected by any of the supplements, however, 2 of the supplements (Trinovin and Prostate Rx) inhibited the growth rate of the normal prostate cell lines while one (Prostate Rx) increased the cellular radiosensitivity of some normal cell lines by inhibiting DNA repair.
The moral of this story is, check with your doctors before taking a dietary supplement while undergoing prostate cancer radiotherapy.
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Early Elective Caesarean Sections Raise Risk of Complications - Often a Caesarean section is scheduled “a little early” to make childbirth “more convenient”, for both the mother and doctor.
The reasons why some women opt to undergo an early elective Caesarean include (a) anxious to see their baby, (b) tired of being pregnant or (c) it is more convenient.
The National Institute of Child Health and Human Development sponsored a large study involving 24,077 full term babies; it found that babies delivered through elective Caesareans at 37 weeks were about twice as likely as newborns delivered at the recommended 39 weeks to suffer from breathing problems, bloodstream infections and other complications. Even elective Caesareans born at 38 weeks were 50 percent more likely to have problems when compared to their 39 weeks counterparts.
Once a woman has had a Caesarean, she is much more likely to deliver subsequent babies by Caesarean.
Pregnancy is traditionally considered full term at or after 37 weeks, however, most international experts, bodies and organizations currently recommend that elective Caesareans should occur no earlier than 39 weeks in order to increase the baby’s chances of being fully developed at birth.
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Eating Disorders - Eating disorders are associated with psychiatric issues that can ultimately lead to life-threatening health complications. People with eating disorders often have a distorted image of their body.
An eating disorder may have a behavioural, learned, emotional, psychological, social or genetic component. Eating disorders were very uncommon in our population two decades ago. Studies have shown that persons with a history of incest or child abuse are more likely to develop eating disorders.
Teenage girls and young women account for 90% of people with eating disorders.
Eating disorders can lead to serious health issues including:
- Disturbances in the heart's rhythm
- Low blood pressure
- Low body temperature
- Kidney failure
- Osteoporosis
- Retarded physical growth
- Irregular periods
- Infertility
- Anaemia
- Acid reflux
- Dental problems
- Constipation
- Dehydration
Substance abuse, depression and anxiety often co-exist in people with eating disorders.
Teens and young adults, who are still developing attitudes about themselves and food, are more likely to respond to therapy. For others, eating disorders can be a lifelong battle. Get help if you suspect you or your child has an eating disorder.
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Eclampsia/Preeclampsia - Preeclampsia occurs when blood pressure exceeds 140/90 after the 20th week of pregnancy, accompanied by protein in urine. When severe, blood pressure exceeds 160/110 and urinary protein is present. This condition occurs in approximately 5% of pregnancies. Other symptoms may include headaches, blurred vision, abdominal pain, swelling of face, hands and lower extremities, reduced urine output and metal disturbances.
Eclampsia, is where seizures occur in women who meets the criteria for having preeclampsia, and does not normally have a seizure disorder.
Complications can include: (a)maternal and foetal death, (b) severe swelling (oedema) of extremities/ face, (c) significant weight gain, (d) retinal detachment, (e) kidney failure, (f) pulmonary oedema (fluid in the lungs), (g) HELLP syndrome (Hemolysis, Elevated Liver enzyme levels and a Low Platelet count Leaky vessels in the liver), (h) low birth weight, (i) brain swelling resulting in seizures and coma, (j) brain damage to the mother caused by brain swelling and oxygen loss during seizures, (k) Blindness in the mother, liver rupture, kidney failure and placental abruption (a life-threatening condition to both mother and baby that occurs when there is a disruption of blood flow to the placenta).
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Ectopic Pregnancy - An ectopic pregnancy is a pregnancy where the developing baby is found outside of the area (i.e. uterine cavity) where it is normally found. The majority of ectopic pregnancies occur in the “tubes” – i.e. the Fallopian tube.
Approximately 1 in every 100 pregnancies is ectopic. The cause of such is generally unknown. However, it is found that some of the following conditions predisposes some to ectopic pregnancies; these include previous ectopic pregnancies, endometriosis and previous pelvic infections.
For the most part symptoms initially are absent or subtle. On average clinical symptoms are only apparent 7 and ½ weeks after the last normal menstrual period. Early symptoms/signs include:
- Pelvic pain and discomfort
- Abnormal period – i.e. late, lighter than normal
- Pain with a bowel movement
Those with a late ectopic pregnancy may experience:
- Vaginal bleeding
- Moderate to severe pelvic/abdominal/back pain – especially on one side
- Shoulder tip pain
- Lightheadedness/Dizziness
