Facts About Elevated Liver Enzymes

High levels of liver enzymes and other chemicals in the blood might mean that you have hepatitis, liver disease or cirrhosis. Signs of hepatitis include stools that are pale in color, fatigue, pain or swelling in the abdomen, and jaundice.

What does the liver do and what are elevated liver enzymes?

The liver is the body’s largest internal organ. It is located below the diaphragm on the right side of the abdomen. The liver performs many functions, including the following:

Produces most of the proteins the body needs.Metabolizes (breaks down) nutrients from food to produce energy.Prevents shortages of nutrients by storing certain vitamins, minerals, and sugar.Produces bile, a substance that helps digest fat and absorb vitamins A, D, E and K.Produces substances that help with blood clotting.Helps your body fight infection by removing bacteria from the blood.Removes potentially poisonous byproducts of certain medications.

What are liver enzymes?

An enzyme is a chemical that accelerates (speeds up) chemical reactions within the body. There are several enzymes in the liver, including alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (GGT). Elevated liver enzymes, found with a blood test, indicate inflamed or injured liver cells.

Why does a doctor check for elevated liver enzymes?

A doctor may order a liver enzyme test if a patient is being treated for liver disease or has a higher risk for liver disease. For instance, if the liver is injured, ALT is released into the bloodstream, and levels of this enzyme would be elevated.

What causes elevated liver enzymes?

Certain diseases or situations can cause a rise in liver enzymes, including:

Hepatitis (inflammation, or swelling, of the liver).

Fatty liver disease (a buildup of certain fats in the liver).

Metabolic syndrome (a collection of heart disease risk factors that increase the chance of developing heart disease, stroke, and diabetes).

Cirrhosis (the liver tissue is filled with scar tissue).

Drug abuse.

What are the signs and symptoms of elevated liver enzymes?

Elevated liver enzymes usually have no signs or symptoms on their own. The doctor may check for elevated liver enzymes in patients who might have hepatitis. The symptoms of hepatitis include:

Jaundice (a yellowing of the skin, whites of the eyes, and mucous membranes caused by liver problems).Pain or swelling in the abdomen.Nausea and vomiting.Dark urine.Pale-colored stools.Weakness.Fatigue.Poor appetite.

The doctor may also order a liver enzyme test for patients who:

Drink a great deal of alcohol or abuse drugs.Have a family history of liver disease.Are overweight.Have diabetes. Read More

Teeth And Gum

How Should I Care for My Teeth and Gums?

There are four basic steps to caring for teeth and gums:

  1. Brushing
  2. Flossing
  3. Eating right
  4. Visiting the dentist

Tips for Brushing

Brush at least twice a day. If you can, brush after every meal. Brushing removes plaque, a film of bacteria that clings to teeth. When bacteria in plaque come into contact with food, they produce acids. These acids lead to cavities. To brush:

  • Place a pea-sized dab of fluoride toothpaste on the head of the toothbrush. (Use a soft toothbrush.)
  • Place the toothbrush against the teeth at a 45-degree angle to the gum line.
  • Move the brush across the teeth using a small circular motion. Continue with this motion cleaning one tooth at a time. Keep the tips of the bristles against the gum line. Avoid pressing so hard that the bristles lie flat against the teeth. (Only the tips of the toothbrush clean the teeth.) Let the bristles reach into spaces between teeth.
  • Brush across the top of the chewing surfaces of the teeth. Make sure the bristles get into the groves and crevices.
  • Use the same small circular motion to clean the backside of the upper and lower teeth — the side that faces the tongue.
  • To clean the inside of the bottom front teeth, angle the head in an up-and-down position toward the bottom inside of the mouth and move the toothbrush in a small circle.
  • For the inside of the top front teeth, angle the brush in an up-and-down position with the tip of the head pointing towards the roof of the mouth. Move the toothbrush in a small circle.
  • Give your tongue a few gentle brush strokes, brushing from the back of your tongue forward. Do not scrub. This helps remove bacteria and freshens your breath.
  • After brushing your teeth for two to three minutes, rinse your mouth with water.
  • Replace your toothbrush with a new one every 3 to 4 months.

Tips for Flossing

Floss once a day. Flossing gets rid of food and plaque between the teeth, where your toothbrush cannot reach. If plaque stays between teeth, it can harden into tartar, which must be removed by a dentist. To floss:

  • Remove about an 18-inch strip of floss from the dispenser.
  • Wind the floss around the middle fingers of each hand, leaving a 1-inch section open for flossing. Floss the top teeth first, then the bottom.
  • Place the floss in your mouth and use your index fingers to push the floss between the teeth. Be careful not to push too hard and injure the gums.
  • Move the floss up and down against the tooth and up and around the gum line. The floss should form a C-shape around the tooth as you floss.
  • Floss between each tooth as well as behind the back teeth.
  • Use a clean section of floss as needed and take up used floss by winding it around the fingers. Read More

Facts About Paget’s Disease

  • Paget’s disease is a chronic bone disorder.
  • Paget’s disease frequently causes no symptoms.
  • Paget’s disease can cause pain in the bones or joints, headaches and hearing loss, pressure on nerves, increased head size, bowing of limb, or curvature of spine.
  • Tests used to diagnose Paget’s disease include X-rays, blood tests, and bone scanning.
  • Paget’s disease can lead to other medical conditions.
  • Medical treatment options include aspirin, other anti-inflammatory medications, pain medications, and medications that slow the rate of bone turnover, decreasing the activity of Paget’s disease.
  • Surgery may necessary for damaged joints, fractures, severely deformed bones, or when nerves are being pinched by enlarged bone.

What is Paget’s disease?

  • Paget’s disease is a chronic condition of bone characterized by disorder of the normal bone remodeling process.
  • Normal bone has a balance of forces that act to lay down new bone and take up old bone. This relationship (referred to as “bone remodeling”) is essential for maintaining the normal calcium levels in our blood.
  • In bone affected by Paget’s disease, one or more localized areas of bone are affected by abnormal bone remodeling, which is disturbed and not synchronized. As a result, the bone that is formed is abnormal, enlarged, not as dense, brittle, and prone to breakage (fracture).
  • Paget’s disease affects older skeletal bone of adults. It’s estimated that 1% of adults in the U.S. have Paget’s disease.
  • There is also an extremely rare form of Paget’s disease in children, referred to as juvenile Paget’s disease.
  • Paget’s disease is also known as osteitis deformans and Paget disease.

What are the types of Paget’s disease of bone?

  • There are two types of Paget’s disease of bone.
    • When a single site of bone is affected by Paget’s disease, it is referred to as the monostotic type.
    • When multiple sites of bone are affected by Paget’s disease, it is referred to as the polyostotic type.

What causes Paget’s disease?

  • It is not known what causes Paget’s disease.
  • Paget’s disease is believed to be a disease of a particular cell that is responsible for bone resorption, the osteoclast.

What are risk factors for Paget’s disease?

  • The onset of Paget’s disease is typically after 55 years of age.
  • Recently, certain genes have been associated with Paget’s disease, including the Sequestrosome 1 gene on chromosome 5.
  • Virus infection may be necessary to trigger Paget’s disease in people who have inherited the genetic tendency to develop the condition by having these genes.
  • Paget’s disease is inherited in approximately one-third of patients. Therefore, it is not uncommon for a patient with the condition to have a family history of the disease.

Who is Paget’s disease named after?

Facts About Urinary Retention

Urinary retention is the inability to empty the bladder. Urinary retention can be acute or chronic. Acute urinary retention is a medical emergency.

Urinary retention is most common in men in their 50s and 60s because of prostate enlargement. A woman may experience urinary retention if her bladder sags or moves out of the normal position (cystocele) or pulled out of position by a sagging of the lower part of the colon (rectocele).

Causes of urinary retention include an obstruction in the urinary tract such as an enlarged prostate or bladder stones, infections that cause swelling or irritation, nerve problems that interfere with signals between the brain and the bladder, medications, constipation, urethral stricture, or a weak bladder muscle.

Symptoms of acute urinary retention are severe discomfort and pain, an urgent need to urinate but you simply can’t, and bloated lower belly. Chronic urinary retention symptoms are mild but constant discomfort, difficulty starting a stream of urine, weak flow of urine, needing to go frequently, or feeling you still need to go after you’ve finished.

Complications include urinary tract infections (UTIs), bladder damage, and chronic kidney disease.
Tests to diagnose urinary retention include taking a urine sample, bladder scan, cystoscopy, X-ray and CT scan, blood test for prostate-specific antigen (PSA), prostate fluid sample test, and urodynamic tests to measure the bladder’s ability to empty steadily and completely.

Treatment for urinary retention includes catheterization, treating prostate enlargement, and surgery.
Urinary retention is the inability to empty the bladder. With chronic urinary retention, you may be able to urinate, but you have trouble starting a stream or emptying your bladder completely. You may urinate frequently; you may feel an urgent need to urinate but have little success when you get to the toilet; or you may feel you still have to go after you’ve finished urinating. With acute urinary retention, you can’t urinate at all, even though you have a full bladder. Acute urinary retention is a medical emergency requiring prompt action. Chronic urinary retention may not seem life threatening, but it can lead to serious problems and should also receive attention from a health professional.

Anyone can experience urinary retention, but it is most common in men in their fifties and sixties because of prostate enlargement. A woman may experience urinary retention if her bladder sags or moves out of the normal position, a condition called cystocele. The bladder can also sag or be pulled out of position by a sagging of the lower part of the colon, a condition called rectocele. Some people have urinary retention from rectoceles. People of all ages and both sexes can have nerve disease or nerve damage that interferes with bladder function.

What is urinary retention?
Urinary retention is the inability to empty the bladder completely. Urinary retention can be acute or chronic. Acute urinary retention happens suddenly and lasts only a short time. People with acute urinary retention cannot urinate at all, even though they have a full bladder. Acute urinary retention, a potentially life-threatening medical condition, requires immediate emergency treatment. Acute urinary retention can cause great discomfort or pain.

Chronic urinary retention can be a long-lasting medical condition. People with chronic urinary retention can urinate. However, they do not completely empty all of the urine from their bladders. Often people are not even aware they have this condition until they develop another problem, such as urinary incontinence — loss of bladder control, resulting in the accidental loss of urine — or a urinary tract infection (UTI), an illness caused by harmful bacteria growing in the urinary tract.

What is the urinary tract and how does it work?

The urinary tract is the body’s drainage system for removing urine, which is composed of wastes and extra fluid. In order for normal urination to occur, all body parts in the urinary tract need to work together in the correct order.

Kidneys. The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine. The kidneys work around the clock; a person does not control what they do.

Ureters. Ureters are the thin tubes of muscle — one on each side of the bladder — that carry urine from each of the kidneys to the bladder.

Bladder. The bladder, located in the pelvis between the pelvic bones, is a hollow, muscular, balloon-shaped organ that expands as it fills with urine. Although a person does not control kidney function, a person does control when the bladder empties. Bladder emptying is known as urination. The bladder stores urine until the person finds an appropriate time and place to urinate. A normal bladder acts like a reservoir and can hold 1.5 to 2 cups of urine. How often a person needs to urinate depends on how quickly the kidneys produce the urine that fills the bladder. The muscles of the bladder wall remain relaxed while the bladder fills with urine. As the bladder fills to capacity, signals sent to the brain tell a person to find a toilet soon. During urination, the bladder empties through the urethra, located at the bottom of the bladder. Read More

What Is Behind Night Sweat?

Night sweats, or excessive sweating during sleep, are a common symptom in women and men.

Doctors treat the problem by diagnosing the cause of your night sweats.

What are night sweats?

Doctors in primary care fields of medicine often hear their patients complain of night sweats because they are common. Night sweats refer to any excess sweating occurring during the night. However, if you keep your bedroom temperature unusually hot or you are sleeping in too many clothes, you may sweat during your sleep, which is normal. In order to distinguish night sweats that arise from medical causes from those that occur because one’s surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.

In one study of 2267 patients visiting a primary care doctor, 41% reported experiencing night sweats during the previous month, so the perception of excessive sweating at night is common. It is important to note that flushing (a warmth and redness of the face or trunk) also may be hard to distinguish from true night sweats.

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What Are Night Sweats a Sign Of?

Medically Reviewed on 2/25/2021

A woman in bed sweating. Many medical conditions and diseases can cause night sweats.Source: Getty Imagesnull

Night sweats facts

Night sweats, or excessive sweating during sleep, are a common symptom in women and men.

Doctors treat the problem by diagnosing the cause of your night sweats.

What are night sweats?

Doctors in primary care fields of medicine often hear their patients complain of night sweats because they are common. Night sweats refer to any excess sweating occurring during the night. However, if you keep your bedroom temperature unusually hot or you are sleeping in too many clothes, you may sweat during your sleep, which is normal. In order to distinguish night sweats that arise from medical causes from those that occur because one’s surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.null

In one study of 2267 patients visiting a primary care doctor, 41% reported experiencing night sweats during the previous month, so the perception of excessive sweating at night is common. It is important to note that flushing (a warmth and redness of the face or trunk) also may be hard to distinguish from true night sweats.

A man in bed with a fever sweating. Night sweats due to the menopausal transition are typically accompanied by other symptoms of menopause such as vaginal dryness, daytime hot flashes, and mood changes.Source: iStock

What are other signs and symptoms of night sweats?

Depending upon the underlying cause of the night sweats, other symptoms may occur in association with sweating. For example:

  • Certain infections and cancers
  • Shaking and chills can sometimes occur if you have a fever.
  • Unexplained weight loss due to lymphoma.
  • Night sweats due to the menopausal transition are typically accompanied by other symptoms of menopause such as vaginal dryness, daytime hot flashes, and mood changes.
  • Night sweats that occur as a side effect of medications can be accompanied by other medication side effects, depending upon the specific drug. Read More

What Is Impingement syndrome?

Impingement syndrome is a common condition affecting the shoulder often seen in aging adults. This condition is closely related to shoulder bursitis and rotator cuff tendonitis. These conditions may occur alone or in combination.

In virtually all parts of your body, bones are the innermost structures and are surrounded by muscles. When an injury occurs to the rotator cuff muscles, they respond by swelling. However, because the rotator cuff muscles are surrounded by bone, when they swell, a series of other events occur.

The pressure within the muscles increases, which results in compression and loss of blood flow in the small blood vessels. When the blood flow decreases, the muscle tissue begins to fray like a rope. Motions such as reaching up behind the back and reaching up overhead to put on a coat or blouse, for example, may cause pain.

What Are the Symptoms of Shoulder Impingement Syndrome?

The typical symptoms of impingement syndrome include difficulty reaching up behind the back, pain with overhead use of the arm and weakness of shoulder muscles.

If these muscles are injured for a long period of time, the muscle can actually tear in two, resulting in a rotator cuff tear. This causes significant weakness and may make it difficult for the person to elevate his or her arm. Some people will have rupture of their biceps muscle as part of this continuing impingement process.

How Is Impingement Syndrome Diagnosed?

Diagnosis begins with a medical history and physical examination by your doctor. X-rays will be taken to rule out arthritis and may show changes in the bone that indicate injury of the muscle. Bone spurs or changes in the normal contour of the bone may be present. Impingement syndrome may be confirmed when an injection of a small amount of an anesthetic into the space under one of the shoulder bones relieves pain.

How Is Shoulder Impingement Syndrome Treated?

It is important to understand that the condition and not just the symptoms require treatment. Oral anti-inflammatory medications ?such as aspirinnaproxen or ibuprofen, remain the most common treatment for this condition.

You must consistently take the medication for nearly eight weeks for it to be effective. Taking anti-inflammatory medications for a short period of time may treat the symptom of pain, but it will not treat the underlying problem and symptoms will come back. There is no specific medication for this condition and response to any given medication differs from person to person. If one anti-inflammatory medication does not help within 10 to 14 days, then another one will be given until one that provides relief is found.

In addition to taking medications, daily stretching in a warm shower will help. Work to reach your thumb up and behind your back. Avoid repetitive activities with your injured arm, particularly where the elbow would move above shoulder level. Avoid vacuuming, painting, raking leaves and washing the car.

If you have persistent symptoms, despite the use of oral anti-inflammatory medications, your doctor may consider a cortisone-type injection. Cortisone is a potent anti-inflammatory medication, which should be used only when necessary because it can result in weakening of muscles and tendons. Read More

FACTS ABOUT FOOD POISONING

  • Food poisoning is a common infectious condition that affects millions of people in the United States each year.
  • Most commonly, people complain of
    • vomiting,
    • diarrhea, and
    • cramping abdominal pain.
  • People should seek medical care if they have an associated fever, blood in their stool (rectal bleeding), signs and symptoms of dehydration, or if their symptoms do not resolve after a couple of days.
  • Treatment for food poisoning focuses on keeping the affected person well hydrated.
  • Most cases of food poisoning resolve on their own.
  • Prevention is key and depends upon keeping food preparation areas clean, proper hand washing, and cooking foods thoroughly.

What is food poisoning?

Food poisoning is a food borne disease. Ingestion of food that contains a toxin, chemical or infectious agent (like a bacterium, virus, parasite, or prion) may cause adverse symptoms in the body. Those symptoms may be related only to the gastrointestinal tract causing vomiting or diarrhea or they may involve other organs such as the kidney, brain, or muscle.

Typically most foodborne diseases cause vomiting and diarrhea that tend to be short lived and resolve on their own, but dehydration and electrolyte abnormalities may develop. The Center for Disease Control and Prevention (CDC) estimates approximately 48 million people become ill from food-related diseases each year resulting in 128,000 hospitalizations, and 3,000 deaths.

According to the CDC, in 2018, the most common forborne illnesses in the United States each year are caused by: 

  1. Norovirus.
  2. Campylobacter.
  3. Clostridium perfringens.
  4. Staphylococcus aureus.
  5. Salmonella.

How do you know if you have food poisoning or the stomach flu?

Food poisoning

Food poisoning and the stomach flu may or may not be the same thing, depending if the causative agent is transmitted by contaminated food, or if the agent is transmitted by non-food mechanisms such as body secretions. Most health-care professionals equate stomach flu to viral gastroenteritis.

Stomach flu

Stomach flu is a non-specific term that describes an illness that usually resolves within 24 hours and is caused commonly by the adenovirus, Norwalk virus or rotavirus, (rotavirus is most commonly found in children).

Norovirus

If numerous cases of viral gastroenteritis occur in a situation where many people have been eating, it certainly may be considered food poisoning. Norwalk virus is responsible for many cases of food borne illness outbreaks on cruise ships.

What are the signs and symptoms of food poisoning?

Food poisoning most commonly causes:

This can cause significant amounts of fluid loss and diarrhea along with nausea and vomiting may make it difficult to replace lost fluid, leading to dehydration. In developing countries where infectious epidemics cause diarrheal illnesses, thousands of people die because of dehydration.

As noted in the section above, other organ systems may be infected and affected by food poisoning. Symptoms will depend upon what organ system is involved (for example, encephalopathy due to brain infection).

What are the symptoms and incubation time for large and small intestinal food poisoning?

Large intestine and small intestine have an intermediate incubation from about 1 to 3 days.

Large intestine

Infections of the large intestine or colon can cause bloody, mucousy diarrhea associated with crampy abdominal pain.

  • Campylobacter, according to CDC data, is the number one cause of food-borne disease in the United States.
  • Shigella spp contaminate food and water and cause dysentery (severe diarrhea often containing mucus and blood).
  • Salmonella infections often occur because of poorly or undercooked cooked and/or poor handling of the chicken and eggs. In individuals with weakened immune systems, including the elderly, the infection can enter the bloodstream and cause potentially life-threatening infections.
  • Vibrio parahaemolyticus can contaminate saltwater shellfish and cause a watery diarrhea.

Small intestine infection

Diarrhea due to small bowel infection tends not to be bloody, but infections may affect both the small and large intestine at the same time.

Everything About Kawasaki Disease

  • Kawasaki disease is a syndrome of unknown cause that mainly strikes young children.
  • Kawasaki disease symptoms and signs include
  • The disease can be treated with high doses of aspirin (salicylic acid) and gamma globulin.
  • Kawasaki disease symptoms usually resolve within a month or two, but the disease should be considered a “lifelong disease” because monitoring for late-onset heart artery changes is necessary.
  • Some children with Kawasaki disease suffer coronary artery lesions.
  • Multisystem inflammatory syndrome in children (MIS-C) is different but with similar symptoms to Kawasaki disease.

What is Kawasaki disease, and how do doctors diagnose it?

The definition of Kawasaki disease is an uncommon illness in children that is characterized by high fever of at least 5 days’ duration together with at least four of the following five symptoms and signs that occur in the acute phase:

  1. Inflammation with reddening of the whites (conjunctivae) of the eyes (conjunctivitis or pinkeye) without pus
  2. Redness or swelling of the feet and/or hands, or generalized skin peeling
  3. Rash on body and/or genital area
  4. Lymph nodes swelling in the neck
  5. Cracking, inflamed lips or throat, or red “strawberry” tongue

Doctors use the above criteria to make a diagnosis of Kawasaki disease. Some investigators consider this phase 1. Phase 2 signs and symptoms may occur during the disease and may include:

  1. Skin peeling (from red palms and finger tips and reddish swollen feet)
  2. Diarrhea
  3. Vomiting
  4. Abdominal pain
  5. Joint pain

In phase 3, signs and symptoms slowly abate if there are no complications. However, the person may have irritability, tiredness, and low energy for 1-2 months.

Doctors sometimes use the terminology “incomplete Kawasaki disease” for patients who receive a diagnosis with only some features of classical Kawasaki disease.

Most patients (about 77%) are under 5 years of age with a peak incidence at 18 months of age. It is the most common acquired heart disease in children. Complications may include long-term effects of heart problems and coronary artery abnormalities like vasculitis.

What is mucocutaneous lymph node syndrome?

Mucocutaneous lymph node syndrome is the original name for Kawasaki disease. The original name was quite descriptive because the disease is characterized by the typical changes in the mucous membranes that line the lips and mouth and by the enlarged and tender lymph nodes. Kawasaki disease is also termed infantile polyarteritis.

What are causes of Kawasaki disease?

The cause is not known. Microorganisms and toxins like that of scarlet fever have been suspected, but none has been identified to date.

  • It is common for Kawasaki disease to occur after a preceding infection, such as tonsillitisear infectionpneumonia, urine infection, or gastrointestinal infection.
  • Genetic factors (genetic variants in some patients) and the immune system (for example, autoimmune disease) seem to play roles in the disease, which is characterized by immune activation.
  • The disease is more common in those of Japanese or Korean descent.

Who develops Kawasaki disease?

Kawasaki disease typically affects children under 5 years of age. Only rarely does it affect children over 8 years of age, in which case it is sometimes referred to as atypical Kawasaki disease. Read More

Put An End To Nail Fingus Once And For All

Many changes in fingernails or toenails may cause people to think they have a fungal infection of the nails, medically known as onychomycosis or tinea unguium.

Fungal infection of the nails sometimes makes the condition sound contagious or related to poor hygiene. In fact, up to 10% of all adults in Western countries have fungal infection of the nails. This percentage increases to 20% of adults who are age 60 or older. Toenail fungus is much more common than fingernail fungus.

In reality, abnormal-looking nails may be caused by a number of conditions including, but not limited to, fungal infection. There are many other reasons why your nails may look different.

Here are some other conditions you may have instead of fungal nails:

  1. Lines and ridges: These are common and may be considered normal. They may worsen during pregnancy. A large groove down the center of the nail can be caused by nail biting. Some people may develop these changes following chemotherapy.
  2. Senile nails: As you age, the nails become brittle and develop ridges and separation of the nail layers at the end of the nail. To avoid this, try to clean solutions and don’t soak the nails in water.
  3. Whitish or yellowish nails can occur due to onycholysis. This means separation of the nail from the nail bed. The color you see is air beneath the nail. The treatment is to trim the nail short, don’t clean under it, polish if you want to hide the color, and wait two to three months. Persistent onycholysis can make the nails susceptible to fungal infection.
  4. Red or black nails due to a hematoma, or blood under the nail, usually occur from trauma (like whacking yourself on the thumb with a hammer). The discolored area will grow out with the nail and be trimmed off as you trim your nails. If you have a black spot under your nail that was not caused by trauma, you may want to see a dermatologist or a podiatrist if it involves a toenail to make sure it is not melanoma (a type of skin cancer associated with pigmented cells). A simple biopsy can rule out malignancy (cancer).
  5. Green nails can be caused by Pseudomonas bacteria, which grow under a nail that has partially separated from the nail bed. This infection may cause a foul odor of the nails. The treatment is to trim the nail short every four weeks, don’t clean it, polish if you want to hide the color, and wait two to three months. It is also advised to avoid soaking the nail in any sort of water (even if inside gloves) and to thoroughly dry the nail after bathing. If the problem continues, there are prescription treatments that your doctor may try.

Facts you should know about fungal nails (onychomycosis, tinea unguium)

Many changes in fingernails or toenails may cause people to think they have a fungal infection of the nails, medically known as onychomycosis or tinea unguium.

Fungal infection of the nails sometimes makes the condition sound contagious or related to poor hygiene. In fact, up to 10% of all adults in Western countries have fungal infection of the nails. This percentage increases to 20% of adults who are age 60 or older. Toenail fungus is much more common than fingernail fungus.

In reality, abnormal-looking nails may be caused by a number of conditions including, but not limited to, fungal infection. There are many other reasons why your nails may look different.

What other conditions can be mistaken for fungal nails?

Here are some other conditions you may have instead of fungal nails:

  1. Lines and ridges: These are common and may be considered normal. They may worsen during pregnancy. A large groove down the center of the nail can be caused by nail biting. Some people may develop these changes following chemotherapy.
  2. Senile nails: As you age, the nails become brittle and develop ridges and separation of the nail layers at the end of the nail. To avoid this, try to clean solutions and don’t soak the nails in water.
  3. Whitish or yellowish nails can occur due to onycholysis. This means separation of the nail from the nail bed. The color you see is air beneath the nail. The treatment is to trim the nail short, don’t clean under it, polish if you want to hide the color, and wait two to three months. Persistent onycholysis can make the nails susceptible to fungal infection.
  4. Red or black nails due to a hematoma, or blood under the nail, usually occur from trauma (like whacking yourself on the thumb with a hammer). The discolored area will grow out with the nail and be trimmed off as you trim your nails. If you have a black spot under your nail that was not caused by trauma, you may want to see a dermatologist or a podiatrist if it involves a toenail to make sure it is not melanoma (a type of skin cancer associated with pigmented cells). A simple biopsy can rule out malignancy (cancer).
  5. Green nails can be caused by Pseudomonas bacteria, which grow under a nail that has partially separated from the nail bed. This infection may cause a foul odor of the nails. The treatment is to trim the nail short every four weeks, don’t clean it, polish if you want to hide the color, and wait two to three months. It is also advised to avoid soaking the nail in any sort of water (even if inside gloves) and to thoroughly dry the nail after bathing. If the problem continues, there are prescription treatments that your doctor may try.
  6. Pitted nails may be associated with psoriasis or other skin problems that affect the nail matrix, the area under the skin just behind the nail. This is the area from which the nail grows. Nails affected by psoriasis can also be tan in color.
  7. Swelling and redness of the skin around the nail is called paronychia. This is an infection of the skin at the bottom of the nail (cuticle). If the infection is acute (has a rapid onset), it is usually caused by bacteria. It may respond to warm soaks but will often need to be drained by a doctor. A chronic paronychia occurs when a cuticle becomes inflamed or irritated over time. Sometimes, yeast will take advantage of the damaged skin and infect the area as well. Therapy begins with keeping the skin dry and out of water. If the problem continues, a physician should be consulted. Antibiotics are not often used but may be necessary in severe infection.
  8. Chronic nail trauma, such as repeatedly starting and stopping, kicking, and other athletic endeavors, can cause damage to the nails that can look a lot like fungal nails. This sort of repetitive trauma can also occur with certain types of employment or wearing tight-fitting shoes. Some traumas may cause permanent changes that may mimic the appearance of fungal nails. Read More

Causes Of Gallbladder Pain

Gallbladder pain is (often misspelled “gall bladder”) an all-inclusive term used to describe any pain due to disease related to the gallbladder. The major gallbladder problems that produce gallbladder pain are biliary colic, cholecystitis, gallstonespancreatitis, and ascending cholangitis. Symptoms vary and may be triggered by eating certain foods. The pain may be described as intermittent, constant, abdominal, radiating to the back, mild to severe depending on the underlying cause.

A brief review of the gallbladder anatomy and function may help readers better understand gallbladder pain. The gallbladder is connected to the liver via ducts that supply bile to the gallbladder for storage. These bile ducts then form the common hepatic duct that joins with the cystic duct from the gallbladder to form the common bile duct that empties into the GI tract (duodenum). In addition, the pancreatic duct usually merges with the common bile duct just before it enters the duodenum. Hormones trigger the gallbladder to release bile when fat and amino acids reach the duodenum after eating a meal, which facilitates the digestion of these foods. Statistics suggest that women may have up to twice the incidence of gallstones than men.

What are the causes of gallbladder pain?

As stated previously, the major gallbladder problems that produce gallbladder pain are biliary colic, cholecystitis, gallstonespancreatitis, and ascending cholangitis. There are two major causes of pain that either originates from the gallbladder or involve the gallbladder directly. They are due to 1) intermittent or complete blockage of any of the ducts by gallstones; or 2) gallstone sludge and/or inflammation that may accompany irritation or infection of the surrounding tissues, when partial or complete obstruction of ducts causes pressure and ischemia (inadequate blood supply due to a blockage of blood vessels in the area) to develop in the adjacent tissues.

Gallstone formation usually happens in the gallbladder, but may form in any of the ducts. When the gallbladder is compressed (squeezed by musculature), bile usually goes out through the bile ducts into the GI tract; however, if gallstones or gallstone sludge is present, there can be partial or complete blockage of the ducts with pressure on the surrounding tissue, sometimes enough to cause local ischemia. Other processes such as trauma can cause gallbladder pain. Infection of the biliary ducts and the gallbladder, usually occurring after gallstone obstruction also can cause pain.

What is biliary colic?

Biliary colic is a term used to describe the type of pain related to the gallbladder, when the gallbladder contracts and the cystic duct is partially or completely blocked by a gallstone. The symptoms are described below.

What are other signs and symptoms of gallbladder pain?

Gallbladder pain may vary or feel different depending on the cause. Many people with gallstones never experience pain. However, there are some variations in gallbladder pain that help the doctor to make a diagnosis.

  • Biliary colic (intermittent duct blockage): Sudden and rapidly increasing pain (ache or pressure) in the right upper abdomen or epigastric area; some people will have pain radiating to the right shoulder (or back pain in the tip of the scapula) and/or also develop nausea and vomiting. The pain usually subsides in about 1 to 5 hours although a mild ache may persist for about a day.
  • Cholecystitis (inflammation of the gallbladder tissue secondary to duct blockage): severe steady pain in the upper-right abdomen that may radiate to the right shoulder or back, abdominal tenderness when touched or pressed, sweatingnauseavomitingfeverchills, and bloating; discomfort lasts longer than with biliary colic.
  • Acalculous cholecystitis (no gallstones) has similar symptoms to cholecystitis but occurs as a complication of other problems like trauma or burns; patients have severe symptoms and appear very ill.
  • Pancreatitis: Gallstones from the gallbladder can block the pancreatic duct and cause pancreatitis (inflammation of the pancreas) with upper abdominal pain that may radiate to the back, tender abdomen, more pain after eating, nausea, and vomiting. Read More

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