GERD – what it is

GERD is a short form for Gastroesophageal reflux disease. The disease is also known by another common name of ‘Acid reflux’. The disease is actually a medical condition caused by the acidic digestive juices present in the stomach. Under some conditions some of this acidic stuff from the stomach abnormally flows back into lower part of the esophagus (food pipe). The term ‘reflux’ in the name of this disease has actually been derived from a Latin word ‘refluere’ which means ‘to flow back’. To understand the problem and how it happens, it will be helpful to first have a basic understanding of the upper gastric tract of the body which is involved in this disease.

The upper gastric tract

Esophagus is the starting point of our upper gastric tract. Also called food pipe, it performs the function of carrying the food swallowed by us, from the throat to the stomach. In the stomach, the glandular cells in the stomach-lining produce the digestive juices which are strongly acidic in nature. In order to guard against the flow back of the acidic mixture of the food and the acids back into the food-pipe (esophagus), there is a muscular ring-valve (sphincter) a little above the entry to the stomach. This one-way valve is designed to allow food to flow down into the stomach but stop the acidic mixture in the stomach from re-entering the esophagus.

How reflux happens

Normally the esophegal valve (sphincter) effectively stops the contents of the stomach from flowing back into the esophagus but sometimes due to a failure of the valve, caused by certain conditions, some amount of the stomach contents can re-enter the esophagus. And as esophegal tissue is not protected like stomach lining by acid proof mucus, they get irritated and get inflamed by such attacks of the reflux from stomach and results in painful and some higly unpleasant gerd symptoms. While many people can tolerate such acid reflux action without experiencing any any severe symptoms, some others having a relatively low acid-tolerance can not cope up with even a moderate amount of reflux, thereby developing a serious inflammation of esophagus-lining.The notirious Heart burn is one such painful and unpleasant sensation caused by the stimulation of nerve ends in the inflamed esophagus. Heart burn is the stinging feeling which usually arises from the upper middle abdomenal area and radiates towards the neck & the heart region. So though called heart-burn, actually heart is not involved at all. Some people and even physicians get mistaken by it as a symptom of a heart attack.

Factors causing acid reflux

There are several causative reasons leading to the deficient functioning of the esophageal valve (sphincter) whereby the gastric acid is able to flow-back into the esophagus. Some of these are as following:

i.              Some types of foods and drinks have the potential to loosen the esophageal sphincter muscles. These can include chocolate, peppermint, fatty foods, alcohol & beverages containing caffeine.

ii.             Heartburn can be triggered by the body position of the person too. For example when the when a person is lying with head/neck area bent backwards or bending down  steeply forward because such positions facilitate the acid-contents in the stomach to enter the food pipe.

iii.            Direct pressure applied on the stomach may make the acid moves upwards into the esophagus and cause the heartburn. Lifting weights, coughing, wearing tight clothing, pregnancy & obesity are some factors which can lead to an bout of heartburn.

iv.           Some medical conditions can also contribute to more cases of heartburn. For example people having hiatal hernia, a disorder of immune system such as the CREST, Raynaud syndrome, and scleroderma make one vulnerable to this condition.

v.            Some medications too can make the lower esophageal sphincter (valve) loose. These are medicines for some heart conditions and blood pressure as well as some asthma drugs like theophylline. Other drugs include some pain killers such as the aspirin, ibuprofen and many other OTC formulatiions.

vi.           Several foods too can irritate esophageal lining due to their acidic content even without the help from the gastric acid. These include the foods that are too spicy, juices of citrus fruits & the fruits themselves including tomatoes, tomato sauces, cigarette-smoke etc.

Common GERD Symptoms

This inflammation of esophegeal lining caused by GERD is called esophagitis which is usually accompanied by the following GERD symptoms in the affected persons:

o    One has a feeling of a heartburn, generally after a large meal.

o    However in severe cases there are recurring bouts of heartburns every few days & about 10 per cent of affected adults experience a painful heartburn almost daily.

o    Thogh in many persons,the heartburn is quite mild & goes away after some time on its own. But in many others acid reflux is common enough to make GERD Symptoms to become severe enough and too frequent to become a serious disabilty.

o    In most GERD patients, the moderate amounts of stomach fluids reentering the esophagus generally remain confined to lower portion of the esophagus. But many a time the flow back is so large that some of it manages to reach upto the mouth thereby leaving an acidic taste. Such a symptom is also called regurgitation.

• In some patients, the gastric reflux leads to unberable pain in the chest and upper abdomen causing an emergency.
• Gerd may cause a feeling  of general sickness and  frequent belching.
• In some cases of complications of  GERD, there are recurring attacks of nausea which lead to vomiting.
• The gastric reflux often damages outer layers of lining of esophagus but if the damage seeps deeper into esophageal wall, an ulcer may form. Ulcers can further damage the blood vessels thereby leading to a condition of the bleeding esophagus in the patients of GERD.

Complications of GERD

If not treated properly, GERD can over lead to chronic inflammation of the esophagus with a number of resulting complications which may include:

1. Esophageal stricture (narrowing of esophagus) – Damage caused to the lining in the lower esophagus by prolonged exposure to acid leads to formation of the scars. The scar – tissue can constrict the food pathway in the esophagus and can lead to difficulty in swallowing.
2. Open sore or esophageal ulcer – Stomach acid with time may erode tissue -lining of the esophagus and forming an open sore or bleeding ulcer.
3. Barrett’s esophagus – It is a complication in which the composition and color of the lining of the lower part of the esophagus change. Such changes are associated with increased risk of developing into an esophageal cancer.

Treatment for heartburn and other signs and symptoms of GERD usually begins with over-the-counter medications that control acid. If you don’t experience relief within a few weeks, your doctor may recommend other treatments, including medications and surgery.

Treatment for heartburn

The initial treatment is aimed at controlling the heartburn includes:

a)    Antacids which are used to neutralize the stomach acid

b)    Medications whose role is reduce the acid production

c)    Medications that heal the inflamed /damaged  esophagus –tissue

d)    Medications to tone up muscles of the lower esophageal sphincter.

If heartburn continues to persist in spite of these initial treatment using easily available OTC (over the counter) drugs, your doctor will have to recommend other prescription-level medications to treat the disease.

Diverticulitis – what it is

Diverticulitis refers to the medical problems created by the diverticula occurring in the large intestine (also called the colon). Diverticula are actually the small pouches bulging outwards which are formed at the weak spots in the wall of the colon. A person having these pouches in his/her colon is said to be having diverticulosis. The condition is an age–related problem and it is estimated that about fifty percent of all the people over 60 years of age have diverticulosis of colon. Diverticulosis is more common in the lower segment of the large intestine called sigmoid colon. But not everybody with diverticulosis actually develops the medical condition called the diverticulitis in which these pouches start creating problems mainly due to inflammation. In fact less than a quarter of the people having diverticulosis go on to  develop diverticulitis while the other majority (more than 75 %) of such people with diverticulosis experience no noticeable discomfort or symptoms because of it.

Causative/risk factors for occurrences of diverticulitis                   

Why & how the diverticula get inflamed to give rise to various diverticulitis symptoms and infections is yet not fully clear. One theory says that the pressure caused in the colon due to constipation etc can be responsible for it. Another theory postulates that the diverticula through their narrow mouths might trap the fecal matter leading to infections. Earlier, doctors were of the opinion that hard nuts, seeds of some fruits like guava, popcorn & corn etc had a role in causing the diverticulitis by getting lodged in the diverticula. However some researchers proved that these foods are not in any way responsible for causing diverticulitis.

Following are some of the risk factors for occurrence of diverticulitis:

Old Age – The diseases afflicts people as they grow old and mostly occurs after 40s.It seem that age-related changes like decrease in strength & elasticity of the colon wall might be a contributory factor for diverticulitis.

Low fiber food – Occurrence of diverticulitis is low in countries and areas where people use a high-fiber diet which helps keep the stools soft and also reduces the chances of constipation. Its incidence is more in developed countries like the United States, with average diet being high on refined carbohydrates & low in fiber content. It is one reason why the diverticular disease incidence rose after the emergence of modern roller flour mills, which resulted into low-fiber flours flooding the market thereby causing a reduction of fiber in the food consumed by people in general.

Obesity – Being significantly overweight has been seen to increase the odds of getting diverticulitis.

Smoking – People smoking cigarettes have been found to be more at risk of developing diverticulitis.

 Common symptoms of Diverticulitis                            

One of the common symptoms of the diverticulitis is the abdominal pain while its common sign seen during a physical examination is the tenderness occurring in lower left part of the abdomen.

Normally, the pain comes on quite suddenly but sometimes it may also be mild & gradually get worse over the days. The severity of the pain can also fluctuate. The affected person can also experience cramps, fever with chills, nausea, vomiting or sudden changes in the bowel habits.

Possible complications of diverticulitis

Diverticulitis, if left untreated in the initial stages can lead to a number of complicated symptoms as following:

a. Rectal bleeding

Rectal bleeding due to diverticula is one of the rare complications. The bleeding occurs when a small blood vessel weakened by a diverticulum gets damaged and starts bleeding. The blood from such bleeding diverticula comes out in the form of rectal blood with the stool. Sometimes this sort of bleeding stops after a while on its own without any medical intervention. If however it is severe and does not stop, surgery may be the only option to remove the bleeding portion of the colon.

b. Formation of Abscess

An infection sometimes occurs in the affected part of the colon and occasionally it refuses to heal. In such cases it can get worse to form an abscess (a small pocket of puss) in the wall of the colon. Normally a small abscess may get cleared up by treatment with antibiotics. However, if it grows and does not clear with even antibiotics, the doctor may have to drain it with the help of a catheter inserted through the skin right into the abscess using a local anesthesia.

c. Peritonitis

Infected diverticula in some cases do develop perforations. The pus can leak out of the colon via these perforations and form an abscess in abdominal cavity. This condition is called peritonitis and can make the affected person extremely ill and become life threatening. Immediate surgery is required in such cases to clean the abscess in the abdominal cavity and for removal of the perforated section of the colon.

d. Obstruction of the intestine

Scarred tissue caused by the infections in the diverticula may result into intestinal obstruction. In such a condition the colon will not be able to move the bowel contents normally. In case of a major blockage of the intestine, an emergency surgery may become necessary.

e. Formation of fistula

A fistula is actually an abnormal & unnatural connection of tissues involving two organs or an organ & the skin. It may be formed when the damaged tissues of two organs come into mutual contact during infection and get joined together to give rise to a fistula. In case of diverticulitis when infection sometimes spreads through perforation outside the colon, the infected tissue from the colon may stick to some nearby tissues to create a fistula. The organs generally involved here are the urinary bladder, the small intestine and the inside of the cavity wall. If the fistula is formed between urinary bladder and the colon which is quite common in case of men, there may be severe chronic infection of the urinary tract. Such a fistula will need to be removed surgically to solve this complication.

Pancreatitis – what it is

Pancreatitis refers to a medical condition in which the pancreas gets inflamed. The pancreas which is a major large gland of the human body lies just behind the stomach in upper right quadrant of the abdominal space adjoining the duodenum – the beginning of the small intestine. The main role of the pancreas is to produce the well known important hormones called insulin & glucagons which are essential for regulating the levels of glucose in our bloodstream and for conversion of glucose into energy required by the body. In the absence of insulin, a person will become what is known as diabetic. Besides these glucose regulating hormones, the pancreas also produces some other equally important enzymes and digestive juices which along with bile secreted by the liver are needed for proper digestion of the food in the small intestine. All these secretions from the pancreas are released through the pancreatic duct into the common bile duct for onward release into the duodenum.

How pancreatitis develops in the body

Normally the pancreatic enzymes produced by the gland become activated to help digest the food only after they reach the small intestine after passing through the pancreatic duct & the common bile duct. However, these enzymes sometimes get activated before leaving the pancreas – that is, while they are still in the small ducts inside the pancreas. Thee activated enzymes can then irritate the cells of the pancreas and cause the inflammation of the tissues. This severe inflammation in the pancreas tissue leads to what is known as acute pancreatitis symptoms. Recurring attacks of such acute pancreatitis can lead to a serious damage and formation of scar tissue in the pancreas, thereby affecting its capacity to function properly. This state of partially damaged pancreas called chronic pancreatitis results into a poor functioning of the pancreas which may further lead to complications like diabetes and various digestion-related problems in the affected person. Both types of the pancreatitis – acute or chronic, occur more in men than in women.

Prevalence of acute pancreatitis in the U.S.    

Acute pancreatitis is the inflammation of pancreas which develops suddenly and also generally subsides in a few days through treatment. Acute pancreatitis can, however, cause severe complications. Every year, over 200,000 persons are hospitalized in the United States because of the acute pancreatitis.

Common Causes of pancreatitis

Gallstones small stone like concretions commonly formed in the gall bladder) entering the common bile duct is one of the major causes of acute pancreatitis. They do so by blocking the opening of the pancreatic duct and thereby causing obstruction in the normal flow of the pancreatic enzymes. The resulting accumulation of enzymes in the pancreas then causes inflammation of the pancreatic cells.

Heavy drinking of alcohol is another leading cause of the occurrence of acute pancreatitis in some people. In fact an acute attack of pancreatitis can sometimes occur just hours after a session of excessive consumption of alcohol. Some other factors which may also cause this condition are:

i.      An abdominal trauma

ii.     As side effects of certain medications

iii.    Due to some infections of the pancreas

iv.   Tumors in the pancreas

v.    Inherent abnormalities in the pancreas.

Common Symptoms of pancreatitis

a.  Acute pancreatitis

A bout of acute pancreatitis ordinarily begins with a gradual but sometimes the onset of a sudden pain in upper abdominal area. The pain may also occasionally extend through to the back. The pain usually becomes worse after eating a heavy oily meal. In some people the pain is constant & severe and may last over several days. As such, a person with this kind of acute pancreatitis looks and feels like very ill needing immediate medical care & attention. Some other common pancreatitis symptoms of an acute condition may include:

i.      A swelling and tenderness in the abdomen.

ii.     The patient may develop fever.

iii.    Pulse rate goes up due to faster heart beat.

iv.   Affected person may feel nausea and may vomit.

v.    May cause a drop in the blood pressure.

vi.   Dehydration is sometimes caused due to heavy bout of vomiting.

vii.  In some rare cases bleeding also occurs in the pancreas which may prove very serious symptom and even fatal.

b. Chronic pancreatitis

Perceptible symptoms of the chronic pancreatitis essentially are quite similar to those of an acute pancreatitis. Chronic patients, however, frequently experience severe pain generally in the upper abdomenal portion as well as the upper back. In some people, such a pain often becomes disabling. Other prominent symptoms of chronic pancreatitis are:

i.              Continuing weight loss which is caused due to poor digestion & malabsorption of food nutirents for want of adequate enzyme production by the affected pancreas.

ii.              Onset of diabetes if the insulin-producing glandular cells of pancreas are damaged by the disease

Diagnosis of pancreatitis

The diagnosis often involves physical examination by the doctor followed by certain blood tests as during the attack of acute pancreatitis, the amount of amylase & lipase- the digestive enzymes produced by the pancreas go up in the blood by about three times or more as compared to the normal levels. In case of doubt the doctor may also order an abdominal ultrasound, CT –scan or an MRI for confirming the condition as well as ascertaining the extent of inflammation in the pancreas.

Treatment of acute pancreatitis

Treatment of acute pancreatitis generally involves the patient’s stay in a hospital for a few days. It becomes necessary for administering the intravenous fluids (like glucose & saline solutions etc as well as the antibiotics & other medications) as the person may not be able to take food & drinks orally for some days. This will also provide necessary rest to the inflamed pancreas for healing. Unless some complications develop, an acute pancreatitis normally goes away in a few days of medical care at the hospital.

Most importantly you need to know what COPD stands for. It is an abbreviation for Chronic Obstructive Pulmonary Disease. This is not a single condition but a triad of three closely related disorders of the lungs – Chronic condition of asthma, emphysema and bronchitis. All the three conditions are characterized by a blockade of the airflow through airways such as bronchi and bronchioles into the lungs and outwards. The condition is generally permanent and often a condition which worsens over time.

Asthma is also a condition where there is obstruction to the flow of air to the lungs the blockade is generally reversible. The airflow in asthma patients is normal except when there is an episode or an attack of asthma. This is hence different from COPD. However when the condition of asthma is ignored to worsen the obstruction caused my turn to be permanent. Such a condition where the patients suffer from a fixed form of obstruction in the flow of air but not just when they have an episode of asthma etc is termed as COPD.

COPD patients are usually labeled with the symptoms that dominate during that period. If the person is most noted with shortness in breath then he is known to be in the emphysema phase. If they cough a lot and have increased production of mucus they are termed as patients of chronic bronchitis. However, it is technically better not to do so as they have more than a single disorder of the lung. In many cases patients suffering from COPD have overlapping symptoms from various conditions at the same time. The patient may be experiencing the symptoms of the chronic bronchitis and asthma at the same time.

What factors can cause COPD?

1.      Smoking (first hand and passive smoking)

It has been proved that 90% of the cases of COPD are caused by smoking in the USA. 15% of all cigarette smokers develop the condition if not all and this 15% of smokers is not a small figure in the United States. The mortality of COPD patients is also high in the people who smoke compared to the people who don’t smoke. The frequency of their symptoms related to the respiratory system is high. They are more vulnerable to cough, breath shortness etc. The functioning of the lungs also degrades at a faster rate than in other COPD patients.  Once the smokers stop smoking the speed of the lung degradation falls to the same as other COPD patients and hence it is advisable to quit smoking as soon as a person can.

Passive smoking has no definite side effect but evidence related to the details collected from the house where parents smoke more kids were more susceptible to infections of the respiratory tract, asthma etc.

Smoking is highly deleterious to the lungs in numerous ways. The smoke of the cigarette is irritating by itself and hence can cause the inflammation of the lungs. The smoke can also cause the release of a substance known as elastase which breaks the elastic fibers in the lungs thus reducing their elastic nature.

2.      Air pollution

Pollution in the air is another major problem for lung diseases. But there is no evidence to prove that air pollution might be responsible for a large problem such as the COPD. Indoor pollution is the most responsible cause in the many other places where the world is not industrialized. The major reason is the use of stoves in homes for cooking.

3.      Occupational pollutants

Occupational pollutants like silica and cadmium are at a higher risk of causing COPD in you. Occupations that pose a risk of COPD are coal mining, metal works, construction works, cotton works etc. These professions almost always pose a risk of interstitial lung diseases. Some occupational pollutants such as cadmium and silica do increase the risk of COPD. The workers involved in the profession also are susceptible to smoking. The risk posed by cigarettes is far higher than the risk posed by the occupational pollutants.

4.      Alpha-1 antitrypsin deficiency

Another most popular reason for the presence of this condition is the lack of the alpha-1 antitrypsin. This is a genetic disorder that can be inherited from parents and this is responsible for 1% of the cases of COPD or lower in the USA. The normal functioning of the lung is dependant on the elastin content in the lungs. This can be damaged by the enzyme elastase and the harmful effects of elastase can be controlled by this protein alpha 1 antitrypsin or AAT.

There are 2 AAT genes in the chromosomes and the AAT genes are dominant variety which means that the inheritance of the genes from either of the parent makes the genes functional. The person lacks the gene when he inherits the defective genes from both the parents. The production of the AAT protein in the liver is controlled by this gene. In people who do not receive functional genes from both parents the COPD onset generally begins at the age of 30 – 40. If the person begins to smoke the cigarettes in the young age the condition may occur even before the age of 30.

Some patients may have one functional and one defective AAT genes and hence the production of AAT by the liver is not as much as in healthy individuals and hence they are at a lower risk that the completely defective genes but at a higher risk than patients with normal functional levels of AAT protein. The chances of COPD increase greatly when these people smoke tobacco.

What COPD symptoms can be observed in patients?

The symptoms of COPD that may be evident due to smoking are as follows

• smoking more than 20 cigarettes per day for a period more than 20 years can manifest as cough that is achronic, dyspnea or breathlessness, and frequently recurring infections of the respiratory tract in the COPD patients.

Emphysema related COPD symptoms

•          The patients who predominantly have emphysema are bound to exhibit symptoms like dyspnea. This shortness in breath can clearly be seen in times of increased activity. In severe cases of emphysema the breathlessness can occur when the person is at rest too.

Chronic bronchitis related symptoms of COPD

•          Such COPD-patients exhibit chronic cough and production of sputum as major symptoms. Usually in most cases the sputum is thick but clear. Infections of the chest may occur occasionally and are responsible for dyspnea, fever, coughing, wheezing and production of cloudy purulent sputum. The wheezing refers to the high pitched sound produced by the lungs while exhaling due to obstruction due to mucous, spasm in the bronchi and loss of the elastic nature of the lungs resulting in the airway obstruction. With the increase in the severity of bronchitis the frequency of the occurrence of the infections also increases.

Symptoms of Advanced COPD

• In this condition of COPD, there is loss of coloration of the skin and there is a bluish tinge present in the nail beds and the lips. This condition of cyanosis is caused by a improper supply of oxygen.
• Due to the poor purification of blood and carbon dioxide drainage from the blood there could be headaches in the mornings.
• There is loss of weight in a few people due to 2 reasons. They consume excess energy to breathe and the intake of food might be reduced to some extent.
• The smaller blood vessels of the lungs are completely destroyed leading to the blockade of flow of blood in the lungs. This increases the work load on the heart to pump more forcefully for the blood to reach the lungs. This leads to a condition of high blood pressure called the pulmonary hypertension. In cases where the heart cannot cope up with the additional work, there is a chance of failure of the heart and this condition is referred to as Cor Pulmonale. This can be clearly observed as swelling in the feet.
• COPD Patients often have sputum with blood when they cough. This is called as hemoptysis. This is caused due to the damage caused to the airway linings and the blood vessels present in the airways. Make sure that you consult your doctor when you see blood in the sputum as it can be an indication of lung cancer too.

Definition: Heartburn is the warm and burning feeling that is experienced in the region of the chest. Though the pain or the burning sensation is felt in the chest the pain is not related to the heart in any way. The burning sensation is caused by the gastric acid present in the stomach.

Frequently experiencing the symptoms of heartburn could in turn be a symptom of a much serious condition called the GERD or gastroesophageal reflux disease. The occurrence of the heartburn frequently or of higher severity can cause great damage to the esophagus by causing ulcers or may prevent you from performing your daily activities. Heartburn can be treated properly by appropriate treatment after understanding the condition properly.

The condition is very common in adults affecting every 30 individuals out of 100 people present. 10% of these people experience attacks of heartburn everyday. This condition of heart burn or related conditions may be present in pregnant women.

What are the causes of heartburn?

The food that we eat moves from the mouth into the esophagus and then into stomach. Esophagus is a hollow tube connecting the mouth and the stomach. At the point of contact of the stomach and the esophagus there is a muscle that regulates the entry of the food and it is called the Lower Esophageal Sphincter. This sphincter is similar to a valve that prevents the backward flow of the food from the stomach to the mouth.

When the food reaches the stomach, the acid present in the stomach acts on the food and digests it. The acid present in the stomach is highly corrosive and can cause great damage to all parts of the body. The stomach is lined with mucous layer to prevent itself from damage. But there is no such protective mucous layer in the esophagus and hence it is susceptible to damage in case the acid reaches the esophagus. The partial closing of the esophageal sphincter can cause the acid to flow to the site of the esophagus and cause burning sensation. This is how an attack of heartburn occurs.

There are several reasons for the partial closing of the lower esophageal valve or sphincter where the gastric acid is allowed to flow into the esophagus.

• Foods and drinks of some types have the potential to make the esophageal sphincter loose. They can include peppermint, chocolate, fatty foods, alcohol and beverages with caffeine.
• Heartburns can occur depending upon the position of the person too. The chances for heartburn to occur are higher when the person is lying or bending down because the chances for the acid in the stomach to reach the intestine are better in these conditions.
• Direct pressure on the stomach or forcing the stomach such that the acid moves backwards into the esophagus have the potential to cause heartburn. Lifting weights, straining yourself, coughing, clothing that is tight, pregnancy and obesity are all factors that can worsen an attack of heartburn.
• Victims of a few medical conditions are more susceptible to cases of heartburn. For instance patients of hiatal hernia, numerous disorder of the immune system like CREST, Raynaud Phenomenon, scleroderma etc and diabetes are vulnerable to the condition.
• Many medications prescribed by the doctors have the potential to make the LES or lower esophageal sphincter loose. They include medicines for heart conditions, blood pressure and asthma drugs like theophylline.
• Several substances have the capacity to irritate the esophageal lining directly without the involvement of the gastric acid and thus leading to heartburn. Some of them are foods that are spicy, juices from citrus fruits and the fruits themselves, tomatoes, tomato sauces, smoke from cigarettes, osteoporosis medicines, aspirin, and ibuprofen.

What are the Heartburn Symptoms that you may experience?

The first sign of heartburn would the pain due to the burning sensation experienced in the chest. In many cases the pain is not limited to the chest. It spreads to other areas of the body like the jaws, arms, throat or the back. This is the major reason for heartburns from being confused for heart attacks. This is a serious condition whether it is really a heart attack or heartburn and hence it would be wisest to seek medical attention at the earliest.

Heartburn is also known popularly as acid indigestion. This generally occurs after 30 minutes to an hour after consumption of meals. The pain increases when you lie down or bend forward. It also increases when you try to forcefully pass out feces. Standing up, drinking water and swallowing saliva can relieve the pain. You can also take antacids to relive pain in case it doesn’t subside with water or saliva.

•          You may often find a part of the food escaping the lower esophageal sphincter from the stomach and reaching your mouth. This process is called regurgitation and the food tastes bitter or sour. This may occur if you lie down or strain immediately after consumption of the food.

•          Gastric acid is highly corrosive to the respiratory tract. This may lead to asthma and a coarse voice. Chronic cough, damage to the teeth due to loss of enamel, sore throat etc can occur. You can also identify presence of lumps in the throat.

•          The exposure of the acid in the stomach over extended periods of time can cause long term damage to the esophagus. This might result in difficulty while swallowing the food. When such a condition is serious it may lead to lower consumption of food and hence loss of weight associated with dehydration. There have also been very few cases where the esophagus was physically damaged by being torn and often bleeding. Such cases have reported to have blood in the cough and the feces that have been passed out but the condition is not as serious in most cases.

When should you seek the advice and treatment from a doctor?

• You should contact your physician when you have no relief in the symptoms even after you have changed your diet, lifestyle and use of medications like antacids. If your heartburn persists for more than 2 weeks with more than 3 attacks per week then you should notify your doctor.
• Heartburns are capable of serious complications and hence immediate help should be available. Ask for emergency services when you experience the following

• Vomiting blood or presence of blood in the feces
• Extreme pain, giddiness and dizziness
• Trouble while swallowing
• Dehydration
• Unintentional loss of weight

NOTE: The pain due to serious problems of the heart can often be confused with heartburn and neglected. Please check for the history of a heart disease in the family and seek medical care to identify the cause of the pain. Please check the condition of the heart if the pain and burning sensation occur along with nausea, sweating, vomiting, and difficulty in breathing, which worsens with more activity.

MRSA infections are resistant to many antibiotics                      

MRSA – what it is

MRSA actually is an acronym for ‘ methicillin resistant staphylococcus aureus’. MRSA is thus a particular strain of the bacteria clasified as staphylococcus aureus( commonly called staph bacteria). Some strains of these bacteria became resistant to a commonly used antbiotic called methicillin (a penicillin based drug). The fact was first noticed by the doctors about 50 years back in 1960s and such resistant staphs got the name as MRSA.In fact over the last 20 years or so  of increasing & inappropiate use of antibiotics,  the bacteria of genus staphylococcus aureus have developed into newer strains of the bacteria which are  resistant to even many other antibiotic drugs besides methicillin. Because of this devlopment these resistant strains are now also referrd to as the “multi-drug resistant staphylococcus aureus”. These bacteria are routinely colonising our skins and frequently give rise to the skin pimples and boils from time to time.

MRSA infections

 As per one estimate about about 33 percent of all the people carry MRSA on the skin or in the nasal passage without even realising it. Such people are the carriers of these bacteria but they are not being caused any harm by germs. Most of these people who are colonized with MRSA in this manner may not develop an infection for years, because one gets MRSA infection only if these bacteria are able to enter one’s tissues or blood and start multiplying inside the body.

People at high risk of MRSA infections

The MRSA infections can be a minor and localized ones like pimples or small boils as well as the more serious ones affecting the blood, bone-tissue, heart or lungs.

People in the following categories/ positions are most vulnerable to the serious MRSA infections:

1. People having a weakened immune system due to various factors / illnesses.
2. Those who have been in a hospital for long durations.
3. People having undergone a surgery recently.
4. People who are lying in the ICU (intensive care unit) of a hospital due to a serious illnesss.
5. Those who go in for tattoos on their body skin.
6. People who share razors, towels and other such items of personal use with others.

Common modes of spread of MRSA
Staphylococcus aureus bacteria are easily transmitted from one person to another though direct skin contact like a handshake or otherwise touching somebody’s skin area by hand. Use of shared bedding, clothing towels,razors and other items/equipment is another common way through which MRSA can spread among people. Because of this strict hygiene is insisted upon in hospitals and good hotels where lot of people of all sorts come to stay and may have to use the beddings and other items of equipment already used by others.MRSA infections are also broadly categorised as the community-acquired (CA) infections and hospital acquired (HA) infections (which are acquired by people during their stay/treatment at the healthcare facilities).
The MRSA bacteria usually enter the body through a wound or via an infected needle piercing the skin.Another way for the MRSA to get into the body is to enter the urinary bladder through a catheter or make the entry into the respiratory tract/lungs through a breathing tube (ventillator). In fact as per data available in the United States, the number of MRSA infections has been increasing fast in the recent years and also the people have been mostly getting infected with MRSA during their visits / treatment at the hospitals. Some reasons for this surprising  phenomenon may be summed up as following:

• More resistant strains of MRSA are developing at a faster rate.
• The medical treatment now involves more often the use of catheters, breathing tubes & central lines which facilitate spread of such staph infections from one patient to another.
• Generally overloaded hospital staff often results in making them compromise with the strict adherence to the regular hand-washing protocols while handling different patients in the course of their jobs.

Symptoms of MRSA infections

MRSA caused skin infections may lead to eruption of a boil -a reddish & painful swelling on the skin anywhere on the body. It may result in oozing of pus and blood from the affected area of the skin. Such boils are common where the skin gets cut or bruised and in skin areas with lots of hair. Other MRSA symptoms affecting the skin include slow healing of wounds, frequent appearances of skin swellings & tenderness and   recurrences of abscess-formation in different parts of the body

Generally hospital acquired MRSA infections are more severe because they mostly occur in the bloodstream or the vital internal organs like  heart, lungs, urinary bladder or the site of a recently done surgery. Symptoms of this type of severe infections may include:

i.      Fever with chills

ii.     Headaches & bodyache

iii.    Cough & chest pain

iv.   Feeling of fatigue & muscle aches

v.    Skin rashes and painful tenderness of skin

vi.   A general feeling of being unwell
Diagnosis of MRSA
If you are frequently coming up with some of the well known mrsa symptoms, you must approach your doctor for a proper diagnosis at the earliest. This will just require a blood or urine sample and in some cases a swab from your wound or boil site. The purpose of the laboratory tests is basically to identify the exact strain of the staphs involved in your infection so that your doctor is able to decide the kind of antibiotics needed to deal with them effectively. Sometimes your doctor may also recommend a screening for the MRSA which may involve taking a series of swab samples from your skin areas, nasal passage and boil or wound, if any.For this purpose you may also be required to be admitted to a health care facility for expediting the whole process of a compehensive screening.
Treatment for MRSA
MRSA infection are generally curable as certain antibiotics are still effective enough for treatment of most of the MRSA infections, though it is also a fact that a number of strains of staphs do not respond to quite a few standard antibiotics. So based on the test reports of your samples, received from the laboratory your doctor will select and  prescribe suitable antibiotics like vancomycin and teicoplanin, which may then have to be administered intravenously for treating MRSA infection affeting your body.

Cervical cancer – a female specific malignancy

Cervical cancer – what it is

The cervical cancer is a female specific disease. It is the cancer that occurs in the uterine cervix of the women.Cervix is basically the mouth (forming the lower part) of the uterus (also known as the womb). Cervix connects the uterus ( where the baby actually grows before birth) to the vaginal canal.

The inside area of the cervix is called the endocervix and is covered with glandular cells.The outer part of the cevix exposed to vagina is known as the exocervix  or the ectocervix and the cells covering this area are called squamous cells. The cervical cancer usually begins in the ‘transformation zone’ where these two types of cell layers meet which is at the tip of the cervix.

Development of the cervical cancer

The cervical cancers mostly starts in the cells of the cervix-lining. The development of cervical cancer is rather a gradual process. The healthy cervical cells first develop into a pre-cancerous form and the over a period of time they eventually become fully cancerous cells.The pre-cancer cell are referred to as cervical dysplasia or cervical intraepithelial neoplasia which basically are the terms for abnormal cervical cells. These pre-cancer changes in the cervical cells can be detected through a screening test known as Pap Test – a technique develped by the Greek scientist , George Papanicolaou in the 1930s.

Due to some unknown reasons, not all the women detected with with pre-cancers (dysplasia) in the cervix actually develop cervical cancer, as in a large number of cases pre-cancer cells vanish on their own without any treatment. In most of the remaining cases the pre-cancer cells normally take many years to become cervical cancer, but in some cases it may happen even within a year. Thus only in some of the women only the  pre-cancerous  cells turn into full-fledged cancers.

Types of cervical cancer

There are the following two main types of  the cervical cancer:

a. Squamous cell carcinoma – This type of cervix cancers occurs in the squamous cells which cover the surface of the exocervix. Squamous cell carcinoma (cancererous growth) mostly begins in the area where the exocervix meets the endocervix ( known as the ‘transformation zone’). Majority (about 80-90 percent of the cases) of the cervical cancer cases are squamous cell malignancies.

b. Cervical adenocarcinoma –  Only 10-20 percent of cervical cancers are of this type but over the last 2-3 decades their number has been on the increase.Adenocarcinoma ,in fact, refers to any cancer occurring in the glandular cells. In this case it is the cancer that  begins in the mucus-producing glandular cells in the endocervix region.

In a few cases of a third type cervical cancer, features of both the squamous cell carcinomas & adenocarcinomas also occur in a woman simultaneously.This type of cancer is called adenosquamous carcinoma or mixed cervical cancer.

Causative/risk factors of cervical cancer

 The researchers have brought out a number of factors which may increase the probability of occurrence of the cervical cancer in a woman. Some of these are mentioned below:

i.     Infection by HPV – HPV (short for the Human Papillomavirus) is a kind of viruses which often infect the cervix in women. HPV infections are in fact very common and most of them clear up of their own or through simple medications. But some types of HPV infections just do not go away and over the period cause pre-cancer changes in the cervical cells which eventually lead to actual cancers. Such HPV infections which linger on have been observed to be the cause of almost all the cervical cancers.

ii.    Neglecting screening through Pap tests: Women who do not bother to get screened regularly through Pap tests are more likely to get cervical cancer. The Pap smear test can detect abnormal cells in the cervix and these pre-cancerous cells can then be removed through treatment available thus preventing the actual cervical cancer

iii.    Deficient immune system – The women with a weakened immunity which can be because of HIV infection or taking certain medicines and drugs which naturally suppress the body’s immune system are at a much greater risk of having a cervical cancer.

iv.   Smoking – HPV infection coupled with smoking cigarettes in a woman has been found to slightly increase the risk of a cervical cancer.

v.    Sexual hyper activity - Women having many sexual partners are at a much higher risk of getting cervical cancer. Similarly a woman having sexual relationship with a partner who might have had sexual relations with multiple partners can also be at a higher risk of having the cervical cancer.

vi.   Use of birth control pills – Using contraceptive pills over a long period especially by women with HPV infection also increases the risk of cervical cancer.

vii.  Giving birth to too many children: Some studies suggest that bearing many children (more than 5) too can slightly put a woman at an increased risk of the cervical cancer in case of she is also carrying HPV infection.

Symptoms of a possible cervical cancer

Cervical cancer at its initial stages usually does not lead to any marked symptoms. It is only when the cancer has progressed that a woman may start noticing one or more of the following cervical cancer symptoms:

1. An abnormal vaginal bleeding that usually occurs in between the menstrual periods.
2. Bleeding can also occur after sexual intercourse or even during a pelvic examination.
3. Bleeding occurring after the stage of menopause.
4. Abnormally longer and heavier menstrual periods.
5. Abnormally high vaginal discharge.
6. Pain in the pelvic region.
7. Painful sexual intercourse.

Some of these symptoms may also be caused in case of a number of infections or other health conditions in the women. But a woman getting these symptoms must inform her doctor about them as early as possible so as to have a proper diagnosis of the underlying problem and timely treatment for the same.

Diagnosis and staging tests for the cervical cancer                           

If a cervical cancer is indeed detected during diagnostic examination by the doctor, further tests and examination will be necessary to determine the stage to which the malignancy has developed as also to determine if the cervical cancer is still localized or has metastasized to other parts of the body.

Treatment of cervical cancer                                   
Treatment of cervical cancer may involve many treatment options which will depend upon the findings of the staging examination. Depending upon various factors, these options may include surgical intervention, chemotherapy and radiation therapy or all of them.
The exact line of treatment will depend mainly upon size of the cancer tumor and also whether the cervical cancer is till confined to the cervix only or has spread (known as metastasis of cancer). The choice of a particular treatment will also depend on your wish (if possible) to have children in future after the treatment is successfully over.

Your doctor will describe you various treatment choices, their expected results & also the likely side effects. You will then work with your doctor to choose and develop a suitable treatment plan which may meet your medical & personal needs, as far as possible.

Endometriosis is a female-specific disorder

Endometriosis – a brief introduction

The term endometriosis is derived from endometrium, the cell tissue which forms the inner lining of the womb (uterus). Endometriosis is, thus, a female specific disease which is quite common among women in the reproductive-age groups. As per one estimate by researchers, more than seven million women in the United States of America alone suffer from this disorder, though many of them may not be actually aware of it. In women afflicted with this disorder, endometrial cells which ordinarily constitute the uterine lining, start growing in other parts of the female body like vagina, fallopian tubes, ovaries, lining of pelvic cavity, bladder, colon, rectum etc and in rare cases, in lungs too.  This kind of abnormal growth of these cells in various organs other than uterus is referred to as endometrial implant. The growth appearing in the form of endometriosis islets, however, is non-malignant in nature.

Prevalence of the disease in the United States

As per one estimate, about 5 to 7 per cent of all the women in the reproductive age group suffer from this disorder in the developed countries of the world. In United States alone about six to seven million women are estimated to be afflicted with endometriosis, while tens of millions more all over the world are suffering from this peculiar affliction. A large number of women having the disease are actually not aware of the fact for want of proper diagnosis or lack of any severe symptoms.

Causes of the disease & risk factors

No definite cause of endometriosis is yet known to the science. However there are a number of theories and hypotheses (but none of them is scientifically confirmed as yet) put forward by the researchers by which they try to explain why endometriosis occurs in some women. Some of these are as under:

• Hormonal imbalance and excessive estrogen levels are believed to be responsible for causing this disorder in women.
• Since endometriosis has been seen to run in families, the disorder is believed to be linked to some genetic defect.
• There is a theory that endometrial tissues may get transplanted by a surgical procedure (like a Cesarean section) in some women. In fact endometriosis implants have actually been found in the surgical scars of women during research studies.
• Some experts are of the opinion that endometrium cells may transport itself from the uterus-lining to other parts through blood/lymph streams due to the person’s faulty immune system which fails to find and prevent endometrial tissue from growing outside the uterus. In fact, it has been found too that women with endometriosis do have certain immune system deficiencies.

As per findings of some empirical studies made by the researchers, the following groups of women are more at risk of having the incidence of endometriosis:

1. Women who never had any children.
2. The women having a close family member with a history of endometriosis.
3. Disease is more common in women between 30 to 40 years of age.
4. Women experiencing longer menstrual periods – lasting more than seven days or shorter menstrual cycles of less than 27 days.
5. Having undergone an injury /damage to the tissue in the pelvic region.
6. Endometriosis cases are more among Caucasian women than in the African American & Asian women.

Endometriosis Symptoms

Many women having endometriosis disorder do not always come up with any specific endometriosis symptoms and therefore such women may not even be aware of their condition. Endometriosis also varies greatly in nature and severity of its symptoms from one woman to another. The symptoms generally synchronize with the timing of the menstrual cycle.

• A most common symptom is the pelvic pain that gets worse before the menstruation and subsides by the end of the menstruation. Women who have this problem generally describe the pain as a continuing aching sort of pain that is deep & radiates to the lower back, abdomen & buttocks. Some women, however, have no pain although their disease is spread over large areas while some others experience severe pains even though there are only some small growths.
• Another common symptom is the pain while having sexual intercourse.
• Infertility is another common result of the endometriosis. About 30-40 percent of the women having endometriosis fail to conceive during their lifetime.
• Pain during bowel movements and urination during the period of menstruation.
• Spotting / uterine bleeding in between the menstrual periods.
• Diarrhea, constipation, bloating, or nausea, especially during menstrual periods

How pain is caused in Endometriosis

Growths of endometrial islets and tissue in various parts of the body are benign (non- cancerous). But they can cause severe pain in the area of their location. This pain causing mechanism of endometriosis is closely linked with the menstrual cycle in the women.  In fact every month, at the time of ovulation in the women, certain hormones secreted by her body cause a built-up of fresh tissue & blood vessels in the endometrium lining of her uterus.  However if the woman does not conceive during the menstrual cycle, her uterus sheds this new tissue and blood vessels which is discharged by the body through the vaginal canal as her menstrual flow. Now what actually happens is that endometrial tissue wherever it may be implanted outside the uterus, too, responds to the hormonal secretions in the body by adding additional tissue & blood and then shedding the same in sync with the uterine wall. The pain is caused by this shedding of the tissues & blood vessels which may cause inflammation and formation of scar tissue in the affected areas.

Treatment for Endometriosis

A wide choice of treatments is available for the women suffering from endometriosis. The actual line of treatment, however, is to be decided by your gynecologist depending upon many factors like your age, severity of the symptoms, the extent of the endometriosis tissue and its spread in your body as well as your desire to have children in future or not.

Treatment of endometriosis generally aims to minimize the fluctuations in a woman’s hormone levels to reduce the stimulation for unpleasant side effects of the endometriosis. Treatment may include administering progestogens, the use of oral contraceptive pills & drugs broadly classified as gonadorelin analogues. Like all hormonal medications, these drugs have wide ranging side effects and it is, therefore, important to know from your doctor about them before commencing such a course of treatment.

Such a medical treatment is normally successful in alleviating the painful symptoms for some time but relapses may happen after the treatment is stopped. Another more lasting & effective way to treat the disorder is the surgical treatment which may include a keyhole surgery (laparoscopic procedure) to remove / destroy the endometrial tissue from the affected areas / parts. A hysterectomy (removal of the uterus) is also suggested in some cases where the symptoms are too severe or painful during menstrual periods and the woman has no wish to have children in the future.

Gonorrhea is a common sexually transmitted infection                                 

Gonorrhea – a brief introduction

 Gonorrhea is one of the several common & well known sexually transmitted diseases (STDs). It is caused by the bacteria known as Neisseria gonorrhoeae. It is also a highly prevalent infectious disease. About 700,000 persons get this infection each year in the United States. It can affect both men and women.

 Mode of transmission of gonorrheal infection

 Gonorrheal infection can come from someone infected by these bacteria through contact with his/her penis, vagina, anus or mouth, where these bacteria usually inhabitate. It does not need an ejaculation of semen to occur during sexual intercourse to acquire gonorrheal infection. Gonorrhea may also be passed on by the infected mother to her baby while still in the womb or at the time of delivery. Thus a

ny sexually active individual can get infected with gonorrhea by having sex with a person carrying the gonorrhea bacteria on his/her body. In United States, the highest gonorrheal infections are reported among sexually active teenagers & young adults –of both the sexes.
Common Symptoms of gonorrhea
Gonorrhea symptoms usually do not just after the actual infection. In case of men, the symptoms can take up to a month or more to appear. Some of the infected people do not show any symptoms at all and may, therefore, remain completely unaware of having contracted the gonorrheal infection. As such people go without getting any medical treatment for the gonorrhea bacteria they are carrying. This not only increases the risk of them exposing to the subsequent complications but also the chances of spreading the infection to others with whom they may have sexual contact.

Gonorrhea symptoms in case of infection in men usually include:

i.      Reddish swelling at the opening of urethra at the tip of the penis.

ii.     Tenderness and swelling in scrotum & testicles.

iii.    White (sometimes yellowish & green) colored discharge oozing from the penis tip.

iv.   A feeling of burning pain during urinating.

v.    Increase in frequency & urgency of urination.

vi.   Throat soreness – known as gonococcal pharyngitis in medical jargon.

Symptoms of gonorrheal infection among women are generally much milder and nonspecific. They are also usually mistaken for other types of infection. The Gonorrhea symptoms in women normally include the following:

i.      Foul smelling vaginal discharge.

ii.     Increased frequency of urination.

iii.    Sharp pain and feeling of a burning sensation while urinating.

iv.   Sore throat due gonorrheal infection entering the mouth through oral sex or kissing the infected sex partner.

v.    Pain during sexual intercourse.

vi.   Severe diffused pain in the lower abdomen due to spread of infection to the fallopian tubes and beyond.

vii.  The infected women may have fever and rashes too, if the infection enters blood stream or spreads to fallopian tubes & stomach area.
Complicated cases of gonorrheal infections
Gonorrheal infections remaining untreated may lead to more serious complicated health problems in the affected persons.

a. Possible complications in women

Some of the possible complications in women are as following:

• There may be scarring of the fallopian tubes (known as salpingitis) which can further lead to problems in conceiving.
• The severe gonorrhea infection in pregnant women may infect the baby while still in the uterus or at the time of actual delivery leading to life-threatening situations for the newly born baby.
• The severe infection may spread to the pelvic cavity though fallopian tubes and over time can take the shape of the pelvic inflammatory disease (PID) in which even abscesses (pockets of puss) are created in the pelvic acvity. More than half a million women actually develop this condition in the U.S. every year.
• It can lead to ectopic pregnancy in which the fertilized egg gets implanted & starts growing outside the uterus.

 b. Possible complications among men

The possible complications due to gonorrhea which occur in men may include:

• Narrowing of the urethra due to scarring of the lining tissue.
• Abscesses (puss-filled small pockets) may be formed in the tissue surrounding the urethra.
• Gonorrhea can also cause epididymitis which is a painful disease affecting the ducts of the testicles & can even cause infertility among men.

In worst cases the ,complications due to untreated chronic gonorrheal infections may lead to even meningitis, heart valve infection or infections of the joints in the infected persons – both men and women.
Testing for gonorrheal infection
Laboratory test for gonorrhea infection is simple and can be done quickly. It is known as the Gram stain test (named after its Danish inventor Hans Christian Gram). It requires a Gram stained sample of discharge (cervical Gram stain for women & of urethral discharge in case of men) from the person suspected of the infection for examination by a pathologist under a microscope. Although this method is quick, it is not considered very reliable by the attending physicians. To be surer they insist upon cultures of the samples which are taken from urethra, vagina, cervix, anus, throat or even blood and joint fluid of the persons to be tested. Testing through cultures can, however, take upto 72 hours for a confirmed diagnosis. It is advisable that persons suspected to be infected by gonorrhea should also be tested for the other common STIs (sexulally transmitted infections).

Preventing gonorrhea                                                    

The risk of gonorrheal infection can be avoided by abstaining from sex with multiple partners and rather being in a long term relationship with a trusted partner who has been tested to be uninfected . Another way is to use the latex condoms consistently & correctly while having sexual intercourse.

As a further precaution to prevent the spread of infection, if a person develops any of the usual gonorrhea symptoms , he/she should at once stop all sexual contact with anyone and approach the healthcare provider immediately for necessary medical treatment.

Gonorrhea is curable

Antibiotics can normaly cure gonorrhea. However with some strains of the gonorrhea bacteria becoming resistant to ceratin antibiotics, it sometimes become more difficult to successfully treat the disease. To counter this problem to some extent, the doctors in the United States are now adopting dual therapy as a rule for treating the cases of gonorrheal infections. Also though the treatment through medication can end the bacterial infection, it would not undo the irreversible damage, if any, already done by the disease deep inside the body of the infected person.

Bladder infection is a common urinary tract infection

Bladder infection- what it is                                                                

A bladder infection here means infection of the urinary bladder. The condition is also referred to as cystitis in medical jargon. Bladder is an important part of the urinary tract consisting of kidneys, ureters, bladder and urethra. The purpose of this pouch-like organ is to store the urine arriving from the kidneys through ureters.The stored urine in the bladder is emptied out by the body through urethra at regular intervals. Bladder infection is one of the many common bacterial infections that affect human beings especially the women. About 1 out of every 3 women (33 per cent) gets bladder infection at one time or the other in her life time. In men, although, the bladder infections are less frequent but these may be more complicated in nature.

How bladder infection takes place

Simple bladder infections – Simple bladder infections are relatively easier to treat and manage. These are generally caused by the external bacteria entering through the urethra opening and traveling upto the bladder. More women get this type of bacterial infections because of their anatomy which makes them comparatively more vulnerable to bladder infections as compared to men. It is so because of the short length of the urethra & the location of the urethral opening (meant for passing out the urine) in women being relatively closer to the anal area and rectum. This makes it easier for a host of bacteria from the rectum (through the anus) travel upto the genital areas around the vaginal/urethral openings. Once there, the bacteria simply have to traverse just a short length of about two inches through urethra to make an entry into the female urinary bladder. As sexual intercourse facilitates propulsion of bacteria through the urethral tract to the bladder, more sexually active women get frequent bladder infections. Wrong practice of wiping from back to front (with toilet paper) after having a bowel movement also helps bacteria move from anal area to the urethra. The bacteria that most commonly infect bladder in women are the E. coli & Staphylococcus saprophyticus which are found in abundance in rectum.

Complicated bladder infections – This type of bladder infections are relatively more difficult to treat.  These involve infections caused due to some abnormalities in the urinary system of the individuals which makes such infections more complicated to treat. Bladder infections in men are generally complicated in nature, because their longer urethra (as compared to women) normally prevents outside bacteria from reaching upto the bladder, thus guarding against the routine (simple) infections so common in women. However, in them the infections generally occur when the normal flow of urine gets obstructed and consequently the urine stays longer in the bladder, thereby allowing the bacteria to multiply & grow there. This abnormal breeding of bacteria can then cause infection in the bladder. One most common reason of obstruction of the urinary flow from the bladder in men is the enlarged prostate gland which generally occurs in older men after 50 years of age. Other reasons for an erratic & irregular passing of urine from bladder can be due to the diabetes or an injury to a nerve/spinal cord.

Symptoms of a bladder infection

Bladder infection leads to inflammation (swelling) of the bladder lining – a condition called cystitis. The bladder infection symptoms normally include some or all of the following:

1. Pressure in the lower abdomen & pelvic area – As the bladder starts to inflate due to the inflammation of its walls, this kind of pressure in the pelvic area of the lower abdomen.
2. Pain during urination (dysuria) – The swelling in the lining of the bladder makes the urine flow into the urethra difficult. This blockage of the exit of urine from bladder leads to heaviness & pain while urinating.
3. Frequent urination (polyuria) - During inflammation such as happens in cystitis, bladder finds it difficult to hold the same volume of urine as a normal & healthy one could. This leads to more frequent need for urination and also a sudden urge to urinate, although only a small amount of urine is passed each time.
4. Need to urinate at night – Normally need to urinate during night is observed in case of pregnant women and men having enlarged prostate problem. However, nocturia (night urination) is also a symptom of a person having cystitis due to bladder infection.
5. Abnormal urine color – If the urine is cloudy or the color is altered abnormally it may be an indication of bladder infection and the you must contact your physician immediately. Cystitis is one of the many urinary tract problems that present with that particular symptom and is one of the easiest to deal with.
6. Foul or strong urine odor – If you start having a urine with an unpleasant odor or it smells rather strongly, there is a strong possibility of its being so due to the unusual build-up of bacteria in the bladder due bladder infection.
7. Bed wetting - A bladder infection among young children often causes episodes of bedwetting as a symptom.

People with advanced & complicated bladder infections may also develop some additional symptoms like fever with chills, nausea & vomiting, pain in the flanks & back or confusion in case of the bacteria spreading from the urinary tract to the blood stream via kidneys.

Prevention of bladder infections

Simple precautions and preventive steps can spare you from a lot of such infections especially if you are a woman. Some of these are as following:

• Try to wipe from front to back while using toilet tissue after bowel movement.
• Make it a habit of urinating invariably after a sexual intercourse.
• Women, who get frequent infections every year, must take a course of the antibiotics after sexual encounters.
• Do not restrain yourself from going to the toilet when you feel the urge to urinate.
• Drinking plenty of water & fluids every day.
• Use of a diaphragm during sexual intercourse also reduces chances of getting bladder infections.
• Some studies have found that drinking of cranberry juice also decrease the risk of urinary tract infections including bladder infections.

Treatment of bladder infections

Simple bladder infections common among women usually are easily treatable with a course of antibiotics as suggested by the attending physician over a period of 3-5 days. Women getting recurring bladder infections (2-3 times a year) better go in for preventive antibiotics, preferably taken after the sexual intercourse.

However the complicated bladder infections mostly seen in men are more difficult to treat and may also need a more prolonged and intensive treatment. Often, the patients in such cases need to take stronger antibiotics over longer periods of 10 days or even more. As the patients also having the severe symptoms like fever, nausea & vomiting etc may have got the infection spread to their kidneys or blood, they might often need to be hospitalized for an intensive supervised treatment.