Health Care and Emphysema

Emphysema is a disease that affects many people, and it typically will lead to death in some cases. Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases, according to the National Institutes for Health (NIH). COPD makes it difficult to breathe.

There are two main forms of COPD, according to the NIH:

•Chronic bronchitis, defined by a long-term cough with mucus.
•Emphysema, defined by destruction of the lungs over time.
Most people with COPD have a combination of both conditions, and smoking is the leading cause of COPD. The more a person smokes, the more likely that person will develop COPD although some people smoke for years and never get COPD. In rare cases, nonsmokers who lack a protein called alpha-1 antitrypsin can develop emphysema. Other risk factors for COPD are:
•Exposure to certain gases or fumes in the workplace.
•Exposure to heavy amounts of secondhand smoke and pollution.
•Frequent use of cooking gas without proper ventilation.
Much more detailed information can also be found on this website: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001153/.

According to eMedicineHealth.com, Emphysema is called an obstructive lung disease because airflow on exhalation is slowed or stopped because over-inflated alveoli do not exchange gases when a person breaths due to little or no movement of gases out of the alveoli. Emphysema changes the anatomy of the lung in several important ways. This is due to in part to the destruction of lung tissue around smaller airways. This tissue normally holds these small airways, called bronchioles, open, allowing air to leave the lungs on exhalation. When this tissue is damaged, these airways collapse, making it difficult for the lungs to empty and the air (gases) becomes trapped in the alveoli.

Normal lung tissue looks like a new sponge, according to eMedicineHealth. Emphysematous lung looks like an old used sponge, with large holes and a dramatic loss of “springy-ness” or elasticity. When the lung is stretched during inflation (inhalation), the nature of the stretched tissue wants to relax to its resting state. In emphysema, this elastic function is impaired, resulting in air trapping in the lungs. Emphysema destroys this spongy tissue of the lung and also severely affects the small blood vessels (capillaries of the lung) and airways that run throughout the lung. Thus, not only is airflow affected but so is blood flow. This has dramatic impact on the ability for the lung not only to empty its air sacs called alveoli (pleural for alveolus) but also for blood to flow through the lungs to receive oxygen.

Emphysema symptoms are mild to begin with but steadily get worse as the disease progresses, according to the Mayo Clinic. The main emphysema symptoms are:

■Shortness of breath.
■Wheezing.
■Chest tightness.
■Reduced capacity for physical activity.
■Chronic coughing, which could also indicate chronic bronchitis.
■Loss of appetite and weight.
■Fatigue.

The Mayo Clinic suggests when to see a doctor if you experience symptoms similar to Emphysema:
■You tire quickly, or you can't easily do the things you used to do.
■You can't breathe well enough to tolerate even moderate exercise.
■Your breathing difficulty worsens when you have a cold.
■Your lips or fingernails are blue or gray, indicating low oxygen in your blood.
■You frequently cough up yellow or greenish sputum.
■You note that bending over to tie your shoes makes you short of breath.
■You are losing weight.

These signs and symptoms don't necessarily mean you have emphysema, but they do indicate that your lungs aren't working properly and should be evaluated by your doctor as soon as possible. Emphysema can increase the severity of other chronic conditions, such as diabetes and heart failure. If you have emphysema, air pollution or a respiratory infection can lead to an acute COPD exacerbation, with extreme shortness of breath and dangerously low oxygen levels. You may need admission to an intensive care unit and temporary support from an artificial breathing machine (ventilator) until the infection clears, according to the Mayo Clinic. More information can be found at http://www.mayoclinic.com/health/emphysema/DS00296.

The single greatest risk factor for emphysema is smoking. Emphysema is most likely to develop in cigarette smokers, but cigar and pipe smokers also are susceptible, and the risk for all types of smokers increases with the number of years and amount of tobacco smoked. Men are affected more often than women are, but this statistic is changing as more women take up smoking. Second-hand smoke can also cause emphysema and lung disease.

Other risk factors, according to Emphysema.org, include:
•Age. Although the lung damage that occurs in emphysema develops gradually over time, most people with tobacco-related emphysema begin to experience symptoms of the disease between the ages of 50 and 60.
•Exposure to secondhand smoke. Secondhand smoke, also known as passive or environmental tobacco smoke, is smoke that you inadvertently inhale from someone else's cigarette, pipe or cigar.
•Occupational exposure to chemical fumes. If you breathe fumes from certain chemicals or dust from grain, cotton, wood or mining products, you're more likely to develop emphysema. The risk is even greater if you smoke.
•Exposure to indoor and outdoor pollution. Breathing indoor pollutants such as fumes from heating fuel as well as outdoor pollutants — car exhaust, for instance — increases your risk of emphysema.
•Heredity. A rare, inherited deficiency of the protein, alpha-1-antitrypsin (AAt) can cause emphysema, especially before age 50, and even earlier if you smoke.
•HIV infection. Smokers living with HIV are at greater risk of emphysema — and of developing the disease at a relatively young age — than are smokers who don't have HIV infection.
•Connective tissue disorders. Some conditions that affect connective tissue — the fibers which provide the framework and support for your body — are associated with emphysema. These conditions include cutis laxa, a rare disease that causes premature aging, and Marfan syndrome, a disorder affecting many different body organs, especially the heart, eyes, skeleton and lungs.

The most essential step in any treatment plan for smokers with emphysema is to stop smoking immediately; it's the only way to stop the damage to your lungs from becoming progressively worse over time. But quitting smoking is rarely easy, according to Emphysema.org, and people often need the help of a comprehensive smoking cessation plan, which may include:

•A target date to quit.
•Relapse prevention.
•Advice for healthy lifestyle changes.
•Social support systems.
•Nicotine gum, tablets or patches and sometimes use of the antidepressant bupropion hydrochloride (Zyban) to help curb the irritability, depression and sleep problems that can occur in the first few weeks after quitting smoking. Much more information about treatment, self-care, prevention, weather related issues, and more can be found at this site: http://emphysema.org/.

Emphysema is a deadly disease, as is COPD. But it is manageable in less severe cases. Also, your doctor can be a great resource to help you battle it. The key is to avoid smoking in any situation as much as possible. If you are a smoker, you need to quit. And, avoid second hand smoke as much as possible. If you feel that you may be experiencing symptoms, go see your physician immediately for a diagnosis. Much information is available online and through medical and health care facilities about emphysema. And it can be encouraging to be around other people who are meeting the same medical challenges you are. If you're interested in a support group, talk to your doctor. Or contact your local chapter of the American Lung Association. It's your life. Take care of it.


Until next time.

Health Care and Colitis

Severe abdominal pain is often associated with a medical symptom known as Colitis, and can be extremely painful. According to HealthProfessor.com, colitis is an inflammation of the large intestine (colon). Colitis is an inflammation of the large intestine that can be caused by many different disease processes. These processes include acute and chronic infections, inflammatory disorders (ulcerative colitis, Crohn's colitis, lymphocytic and collagenous colitis), lack of blood flow (ischemic colitis), and history of radiation to the large bowel. Symptoms can include abdominal pain, diarrhea, dehydration, abdominal bloating, increased intestinal gas, and bloody stools.

All types of colitis are associated with inflammation of the colon, though some types may be more severe and potentially dangerous than others. When a patient complains of pain and diarrhea with or without bloody stool, it is important to diagnose the type of colitis since treatments are different for the different types of colitis, according to MedicineNet.com. Many bacteria normally reside in the colon; they live in harmony with the body and cause no symptoms. However, if disease-causing bacteria are ingested with bacteria-contaminated foods, these bacteria may infect the small intestine and/or colon. Sometimes colitis may occur after antibiotics have been prescribed for an infection elsewhere in the body. The antibiotic suppresses some of the normal bacteria within the colon and allows an overgrowth of another type of bacteria, some of which can lead to colitis.

The colon can be thought of as a hollow muscle, according to Medicine Net. It requires a supply of blood to bring oxygen and nutrients in order for the muscles to function normally. When the colon loses its supply of blood and becomes ischemic (isch= restricted + emia=blood supply), it may become inflamed. Ischemia or lack of blood supply causes pain, fever, and bloody bowel movements. Ulcerative colitis and Crohn's disease are the two types of inflammatory bowel disease (IBD) that give rise to colitis. Ulcerative colitis always begins in the rectum and sigmoid colon and frequently progresses over time through the ascending, transverse, and then ascending colon. It is thought to be a disease caused by overactivity of the immune system and usually causes abdominal pain, and bloody, diarrheal bowel movements. Crohn's disease may occur anywhere in the digestive tract - in the esophagus, stomach, small intestine, or colon - though it is most commonly involves the small intestine and colon. In Crohn's disease there may be "skip lesions," that is, abnormal segments interspersed between normal segments. If segments of the colon are involved, then symptoms of colitis may be present.

Colitis may be identified by flexible sigmoidoscopy or colonoscopy -- in both of these tests, a flexible tube is inserted in the rectum, and specific areas of the colon are evaluated. Biopsies taken during these tests may show changes related to inflammation, according to Health Professor.com. Other studies that can identify colitis include:
•Barium enema.
•Abdominal CT scan.
•Abdominal MRI.
•Abdominal x-ray.
Treatment is directed at the underlying cause of disease, whether it be infection, inflammation, lack of blood flow, or another cause. The prognosis varies with each disease. Colitis may result in bleeding, ulceration, perforation (a hole in the colon), or toxic megacolon. Call your health care provider if you have symptoms like abdominal pain, abdominal distention, or blood in the stool.

Common symptoms associated with colitis are abdominal cramping, frequent loose stools or persistent diarrhea, loss of control of bowel function, fever, sleepiness, and weight loss. Depending on the cause, colitis may be treated in several ways, according to WiseGeek.com. One of the first steps in diagnosing colitis is identifying the cause. Some forms of colitis may be caused by infection through bacteria, certain viruses, and some parasites. For example, exposure to the salmonella bacteria or any other bacteria needs to be treated with antibiotics to resolve the condition. Parasitic or amoebic infection usually warrants a course of either antibiotics or anti-parasitic medication. Viral colitis can be more difficult to treat.

Viruses like Rotavirus or Norovirus can result in dehydration, particularly in the very young or very old. Rest and increased fluid intake are often prescribed, according to Wise Geek. However, if a person becomes severely dehydrated, he or she may need care in a hospital to receive intravenous fluids. Certain diseases can predispose one to attacks of colitis. The most frequent cause of colitis in those with intestinal diseases is Crohn’s disease, which is a degenerative intestinal disorder. People with Crohn’s are more prone to colitis and to other serious conditions like perforated bowel. Those with Crohn’s need to take seriously the symptoms listed above and see a doctor immediately. Any of these symptoms can necessitate medical treatment. Irritable bowel disorder (IB) can also cause bouts of colitis. Since IB is both difficult to diagnose and to treat, anyone who has had frequent recurrences of the symptoms above is prone to colitis and should contact a doctor if he or she suspects colitis. Especially if bacteria or parasites causes the colitis, this can only worsen IB and needs immediate treatment.

While antibiotics are used to treat bacterial colitis, they can also be indicated as a cause of colitis in some cases. Additional causes of colitis may include taking birth control medication, having autoimmune disorders, or smoking. If diarrhea and fever persist for more than two days, and you don’t have a disease that would necessitate earlier treatment, you should see a doctor quickly. If you have severe stomach pain with fever, you should not wait to see a physician during office hours but proceed to the emergency room, as this may indicate appendicitis or bowel injury. If you suspect food poisoning, it is better to go the emergency room, since some bacteria can be very harmful, according to Wise Geek. You can reduce your risk of colitis by using sanitary cooking and eating practices, avoiding caffeinated beverages, and not taking medications like ibuprofen if you have irritable bowel or inflammatory bowel conditions. Treatment for those with frequent bouts of colitis will focus on trying to reduce symptoms such as diarrhea and stomach cramping. Sometimes these treatments of symptoms are the only way to address colitis. Yet even with treatment, those with Crohn’s and other autoimmune or known stomach disorders should be vigilant if they suspect colitis, since other more serious conditions may also have the same symptoms as colitis.

What Factors Increase Your Risk of Getting Colitis? While the exact cause of colitis is not yet known, certain factors make it more likely a person will develop the disease, according to EverydayHealth.com. These include:
Age: While colitis can begin at any age, it usually starts when people are between 15 and 30 years old. Family history: Up to 20 percent of people with colitis have a close relative with ulcerative colitis or Crohn's disease.
Ethnic background: There is a higher incidence of ulcerative colitis in whites than in non-whites, and a higher incidence among Jews than in non-Jews.
Where you live: Ulcerative colitis occurs mostly in developed countries, and is found more often in urban areas than rural ones, and in northern regions rather than southern regions.
 
In general, according to Everyday Health, a treatment plan may include:

--Medications which reduce inflammation and treat the symptoms of ulcerative colitis to prevent them from coming back. The four main categories of medication are aminosalicylates, corticosteroids, immunomodulators and biologic therapies.
--Surgery may be recommended at some point in the course of the disease. About 25 percent to 40 percent of people with ulcerative colitis eventually have their colon removed. Some opt for surgery after drug therapy fails to control severe and ongoing symptoms. Surgery may also be necessary if a person suffers serious complications from ulcerative colitis.

There is no cure for colitis, but with the right treatment, the disease can be well-managed. Among the best ways of controlling colitis is aggressive treatment in the early stages of the disease so that you maintain remission and your symptoms do not get worse. Adherence to your treatment plan and communication with your doctor about your symptoms or treatment side effects are key to living comfortably with the disease. Research has shown that ulcerative colitis may make it more likely that a person will develop arthritis, eye inflammation, liver diseases and osteoporosis. Scientists do not know how or why colitis influences these other health problems, but they think inflammation triggered by the immune system may play a part. In some cases, the conditions that occur outside of the large intestine go away when the colitis is treated. About 5 percent of people who have ulcerative colitis develop colon cancer, which is a higher rate than for people without ulcerative colitis. The risk of colon cancer increases in each decade after ulcerative colitis is diagnosed, according to Everyday Health. More info can be found at this site: http://www.everydayhealth.com/colitis/10-key-questions-about-ulcerative-colitis/what-is-ulcerative-colitis.aspx .

Colitis is a very serious medical issue that needs immediate attention if you suspect that you may be experiencing any of the symptoms. To prevent more serious health care issues, and to get the proper prescribed treatment, go to your family physician or closest medical clinic to get treated. If your symptoms get worse or don't go away, do not delay seeking medical care as the problem only gets more severe and may result in more critical health issues. Make sure that your doctor is aware of any family history of colitis or any symptoms that have been recurring with you relative to this disease. Always seek proper health care advice from a qualified medical provider for this or any other symptoms.
 
Until next time.