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Internal Medicine Diseases

Abdominal Pain

Abdominal pain is a common symptom that affects people of all ages for many different reasons. Abdominal pain may be acute or chronic, and may develop as a result of constipation, diarrhea, gas, appendicitis or a bladder infection. It may be a sharp or dull pain, may occur in just one area of the stomach or all over, and the pain may be constant or may come and go. Patients with abdominal pain often suffer from nausea, vomiting, fever and fainting as well.

Treatment for abdominal pain usually focuses on treating the underlying cause of the pain. Most conditions can be effectively treated with medications, fluids or rest. Relieving stress and eating a healthy and balanced diet can also help control abdominal pain in many cases.

Anxiety

Social anxiety disorder or social phobia is the most common anxiety disorder and affects over 19 million people in the US. People with social anxiety have excessive and unreasonable fears of different social situations. They may feel overly anxious and nervous in everyday situations.

Social anxiety affects people emotionally and physically. The emotional fear of being judged, watched or embarrassed can lead to:

  • Profuse sweating
  • Blushing
  • Shaking
  • Confusion
  • Nausea/upset stomach
  • Diarrhea

Like other mental health conditions, the causes of social anxiety disorder are believed to be a result of genetics, biochemistry and environment. This condition most likely begins during adolescence and early adulthood. Although minor social phobias are common among most people, these phobias should not affect your daily life. If they do, you should see a doctor who may diagnose social anxiety disorder. Cognitive-behavior therapy is the most effective treatment for social anxiety because it guides patients to have more rational thoughts about social situations. Medication is also available to help treat symptoms.

Arthritis

Arthritic joints are swollen, or inflamed, usually because the smooth cartilage around them has been damaged in some way. Patients with arthritis suffer from pain, stiffness and swelling in the affected area(s).

Nearly one in three adults suffers from arthritis or other chronic joint symptoms. Arthritis is the most common chronic ailment among the elderly, although it can affect people of any age, including children.

There are over 100 different types of arthritic diseases. The most common is osteoarthritis, a degenerative joint disease in which the cartilage protecting the bone ends wears away. At first, discomfort results from inflammation in the joint. Then, as the condition progresses, the worn bones rub together with painful friction whenever the joint moves. Osteoarthritis frequently affects weight-bearing joints such as the spine, hips and knees.

Rheumatoid arthritis is a chronic condition in which the body’s own immune system attacks the joint lining. This autoimmune disorder usually affects the hands and feet and can cause pain even when the joint is not being moved.

A diagnosis of arthritis is made after an evaluation of symptoms, a physical examination and one or more diagnostic imaging tests.

Unfortunately, most types of arthritis are currently incurable – but today’s treatment options can be very effective. Treatment typically involves a combination of anti-inflammatory medication and devices to relieve stress on the joint (canes, crutches or splints). Regular exercise, weight loss for overweight patients, and cortisone injections may also be helpful. In severe cases, orthopedic surgery such as joint replacement may be the only way to improve or restore function and relieve pain.

Cholesterol

Cholesterol is an essential fat found in every cell in the body and used to produce hormones like vitamin D and bile. While a certain amount is necessary, too much cholesterol is unhealthy and blocks the blood from flowing through the arteries. This can eventually lead to a stroke. Cholesterol levels can be controlled through an active and healthy life.

There are three different types of cholesterol, some of which are healthier than others. Low-density lipoprotein (LDL) is the "bad" cholesterol that builds up in the walls of the arteries and blocks blood flow. Very-low-density lipoprotein (VLDL) also narrows the blood vessels and contains the most triglycerides, another type of fat that can lead to pancreatitis if too much is present. High-density lipoprotein (HDL) is the "good" cholesterol that carries extra cholesterol back to the liver.

High levels of "bad" cholesterol can lead to several serious complications, including atherosclerosis, heart attack and stroke. There are no symptoms associated with high cholesterol, so it is important to monitor your levels on a regular basis. Your doctor can check your cholesterol levels through a blood test called a lipid panel.

Life changes are usually the first line of defense against high cholesterol. A low-fat diet and losing weight in general can help lower LDL and triglyceride levels. More aggressive treatment methods may be needed if total cholesterol and LDL levels are still high. Medications or hormone replacement therapies may be used, but a healthy life must also be maintained. These steps can also help prevent high cholesterol. Talk to your doctor about your potential risks and what you can do to reduce them.

Congestive Heart Failure

Congestive Heart failure occurs when the heart can't receive enough blood to oxygenate or pump enough blood to sufficiently supply the rest of the body. This condition usually develops over time as the heart weakens from disease or defects and cannot pump properly. Although congestive heart failure does not mean that the heart stops, it is still a serious condition that requires medical attention.

Congestive Heart failure is usually a chronic condition, but symptoms can sometimes appear suddenly. Symptoms that appear suddenly may be more severe and can quickly worsen. Common symptoms of heart failure include:

  • Fatigue
  • Weakness
  • Irregular heartbeat
  • Shortness of breath
  • Swelling of legs, ankles and feet
  • Weight gain
  • Coughing

Chronic congestive heart failure usually requires lifelong treatment to manage symptoms and prevent permanent damage. Treatment for heart failure aims to treat the underlying cause of the condition and prevent it from worsening through a combination of medications, surgery and medical devices.

COPD

Chronic obstructive pulmonary disease (COPD) is a progressive condition that involves a constant obstruction of the airways that results in difficulty breathing. COPD can be classified as either emphysema or chronic obstructive bronchitis, both of which usually develop from long-term cigarette smoking, but can also be caused by other irritants such as air pollution and chemical fumes. This condition affects nearly 12 million people in the US and is the fourth most common cause of death. 

Causes of COPD

Most cases of COPD are caused by long-term exposure to lung irritants such as cigarette smoke, secondhand smoke, air pollution and chemical fumes that damage the lungs and irritate the airways.

COPD is most commonly diagnosed in middle-aged and older adults, although some younger patients may be diagnosed because of an alpha-1 antitrypsin deficiency, a genetic condition.

Symptoms of COPD

Patients with COPD often experience:

  • Chronic cough with mucus (smoker's cough)
  • Shortness of breath
  • Wheezing
  • Tightness in the chest 

These symptoms are common among many smokers, and may be present years before COPD is diagnosed. Patients with COPD may also experience frequent colds or flu, along with swelling in the ankles, feet and legs in severe cases. Symptoms worsen over time, and may require a hospital stay if they become severe enough or do not respond to treatment.

Diagnosing COPD

After evaluating your symptoms and medical history, your doctor may perform lung function tests in order to diagnose COPD or a chest X-ray. A lung function test measures how much air you can breathe in and out, how fast you breathe and how well the lungs carry oxygen to the blood. The most common lung function test is called spirometry.

Treatment of COPD

Since COPD is a chronic condition, there is no cure currently available. Treatment focuses on relieving symptoms and slowing the progress of the disease, allowing patients to enjoy an active and healthy life. The most important step that patients can take in treating COPD is to quit smoking. Your doctor may also prescribe medication to relax the muscles and relieve inflammation around the airways, oxygen therapy or pulmonary rehabilitation. Surgery may be performed for severe cases of emphysema to clear the airways from large obstructions.

Depression

While everybody feels sad or blue every once in a while, many people suffer from an actual medical condition, known as depression, that affects their lives on a daily basis. Depression is characterized by constant feelings of sadness or emptiness, and may be triggered by certain events or co-exist with other illnesses.

There are several different depressive disorders, but major depressive disorder is the most common. Symptoms of major depression include:

  • Feeling sad or hopeless
  • Loss of interest in normal activities
  • Crying spells
  • Trouble sleeping
  • Trouble concentrating
  • Irritability
  • Fatigue
  • Aches and pains
  • Suicidal thoughts

Like other psychological disorders, the cause of depression is not specifically known, but is believed to be a combination of genetic, biological and environmental factors. Depression often occurs with other illnesses including anxiety disorders, substance abuse, heart disease, stroke and cancer.

Although depression can be a serious condition, it is highly treatable. It is important to talk to a doctor if you are experiencing symptoms to help prevent the condition from worsening. Treatment of depression typically includes medication and psychotherapy. Following effective treatment methods can help make depression a manageable and much less dangerous condition.

Dermatitis

Atopic dermatitis, a form of eczema, is a chronic skin disorder that causes dry, itchy skin and often results in a red rash. It is most common in babies and children, and tends to affect those with a family history of allergies and asthma, although the actual cause is unknown. Atopic dermatitis can affect different areas of the skin, but is most commonly found on the face, neck, arms and legs. It is usually mild and can go away on its own, but may be more severe if it affects a larger area.

Although atopic dermatitis cannot be cured, it can usually be treated and controlled simply through using moisturizing lotions, avoiding harsh soaps and controlling scratching.

Contact dermatitis involves an inflammation of the skin caused by contact with a foreign substance. Common triggers of contact dermatitis include poison ivy, certain foods, cleaning products, detergents, cosmetics and latex rubber. When a patient comes in contact with one of these triggers, he/she may experience a red rash, blistering, itchiness, dryness and more. Symptoms caused by contact dermatitis may be a result of an immune system reaction or from an external allergic reaction to the specific trigger.

Most cases of contact dermatitis do not require treatment and will go away on their own within a few weeks. Patients can help relieve symptoms by avoiding the trigger, washing the affected area and applying hydrocortisone cream or taking oral antihistamines. 

Diabetes

Diabetes is a chronic condition that affects over 20 million people in the US - nearly 7 percent of the population. Diabetes is a metabolic disorder in which the body does not produce or absorb enough insulin, a hormone that moves glucose into the bloodstream.

Most of the food that we eat is broken down into glucose, which is the main source of fuel in the body. If there is not enough insulin, or the insulin cannot be utilized properly, the glucose cannot fuel our body. This causes a buildup of glucose that then passes out through the urine.

There are several different types of diabetes that affect the body in different ways:

  • Type 1 Diabetes is an autoimmune disease that attacks the body's insulin-producing cells.
  • Type 2 Diabetes includes an ineffective use of natural insulin and is affected by age, weight and family history.
  • Gestational Diabetes occurs in pregnant women and involves a shortage of insulin. This puts women at a higher risk for type 2 diabetes.

Treatment of diabetes includes maintaining a healthy diet, active life and monitoring blood glucose levels. Insulin injections or oral medications are needed for many people as well. Managing diabetes requires a lifelong commitment of daily treatment in order to prevent complications. If glucose levels get too high or low, you may experience hyperglycemia or hypoglycemia. If not treated properly, diabetes can lead to heart disease, stroke and kidney failure. It can also cause permanent eye, foot, skin and bone damage.

Ear Infection

Ear infections are one of the most common diseases in children and occur most often between the ages of four months and five years, although older children and adults may be affected as well. An infection occurs when excess fluid, often as a result of a cold, becomes trapped in the eustachian tubes or infected by bacteria. This fluid pushes against the eardrum and causes pain.

Aside from pain, ear infections can also cause:

  • Hearing loss
  • Fever
  • Irritability
  • Discharge from the ear canal
  • Difficulty sleeping

Although an ear infection can cause your child pain and may result in crying, sleepless nights, there is no real treatment method. Ear infections usually go away on their own and are not helped much by antibiotics. Over-the-counter pain relief is often recommended, but otherwise there is no standard treatment for this common condition.

Fever, General Malaise

A low-grade fever and general malaise (a feeling of overall discomfort and uneasiness) are common symptoms that often develop as a result of upper respiratory infections such as the flu, strep throat, bronchitis and sinusitis. These symptoms are usually present along with others such as a runny nose, headache, sore throat and nausea, depending on the individual condition.

For most patients, these infections and their corresponding symptoms can be effectively managed through over-the-counter medications. It is also important for patients to rest and drink plenty of fluids to help relieve symptoms. In most cases, fever and general malaise are not life-threatening conditions, but can severely affect a person’s quality of life for a few days.

Hypertension

High blood pressure occurs when the pressure of the blood flowing against the blood vessel walls is above the normal range. It is also known as hypertension. It is written in two sets of numbers, as an example, 120/70. The first number is the systolic reading, which is the pressure when the heart is beating. The second number is the diastolic number, the pressure when the heart is resting. High blood pressure occurs when the systolic reading is elevated above 140 or higher and/or the diastolic reading is 90 or above.

The causes of high blood pressure are not exactly known. It cannot be cured but it can be controlled with changes to your life and medicine prescribed by your doctor. Almost 1 out of 4 Americans have high blood pressure and most of them don't know that they have it. High blood pressure doesn't have any signs, which is why it is so dangerous.

Who is at risk for High Blood Pressure?

People who are at risk for high blood pressure usually have one or more of the following factors:

  • Close relatives with high blood pressure
  • African-American
  • Over 35 years of age
  • Overweight
  • Excessive use of salt in food
  • Alcohol consumption
  • Women using oral contraceptives
  • Physically inactive
  • Pregnant women

How do I know if I have high blood pressure?

Usually you cannot tell if you have high blood pressure. You can get blood pressure readings during your physical exam.

What can happen to me if I don't treat my high blood pressure? 

High blood pressure is a serious condition. If you do not treat it, you may experience heart failure, kidney failure, a heart attack, stroke or death.

How can I control my high blood pressure?

There are several things that you do to reduce your blood pressure.

  • Lose weight if you are overweight
  • Eat a healthy diet that is low in salt and fat
  • Limit your alcohol to no more than two drinks a day
  • Become physically active
  • Take the medicine your doctor prescribes for you
  • Know what your blood pressure should be and work to keep it at that level

Knee Pain, Back Pain

The constant use of the lower extremities makes them an easy target for injury and pain, specifically in the knees and feet. Walking, sitting and standing all put pressure on our knees and feet, while most athletic activities rely on them as well. Knee and foot pain are common ailments that affect thousands of people in the US each year. These symptoms may be a result of the same condition or can be completely separate. It is important to determine the source of the pain in order to successfully treat these conditions.

Knee Structure

The knee is a hinge joint that connects the thigh bone (femur) to the lower leg bones (tibia and fibula) and the kneecap (patella). Like other joints in the body, the knee is made up of tendons and ligaments, as well as cartilage structures like menisci and bursae. The tendons and ligaments provide strength and stability and allow the knee to evenly carry the weight of the body, while the cartilage structures allow for smooth, fluid movements.

Causes of Knee Pain

Any of these structures can be damaged by injury, disease or other conditions that may result in knee pain. Knee pain is often a result of:

  • Trauma
  • Overuse
  • Sudden turning movements
  • Awkward landings from falls
  • Infection
  • Degeneration.

Injury is one of the most common causes of knee pain and can sprain, strain or bruise any of the joint structures. Bones can fracture as a result of major trauma. Degenerative diseases like arthritis are also a common cause of knee pain, as they cause the cartilage between the bones to wear away.  Bursitis is an inflammation of the bursae.

Because of the different structures involved, amount of use and wide range of diseases and injuries, knee pain can greatly vary. Pain may be severe ad constant, or may be more of a dull ache that comes and goes.  You may have difficulty walking or standing, experience stiffness or loss of motion. A fever can also be present if the pain is caused by an infection. Injury to the knee is likely to cause sudden, severe pain, while pain caused by disease may be more gradual and mild.

Knee pain is more likely to affect people who:

  • Are overweight or obese
  • Exert excessive use of the knee
  • Play high-risk sports
  • Are older
  • Lack muscle strength and flexibility

Back Pain

The lower back is one of the most important parts of the body, as it holds most of our body weight when we stand and is involved in the movement when we bend or twist at the waist. Because of its pivotal role and frequent use, it is susceptible to injury and chronic pain. Lower back pain is especially common in older adults, who may have decreased bone strength and muscle elasticity. The cartilage in between each vertebral disc may have worn away as well.

Lower back pain can be a result of a muscle sprain, strain or spasm, a ruptured or bulging disc or an irritated nerve. The pain may radiate down the legs as well. Obesity, smoking, poor physical condition and poor posture can create a higher risk for lower back pain.

While lower back pain is not usually a serious condition, it can be very painful and debilitating. Treatment for this pain is usually simple and can include medication, ice and heat, rest and exercise. Talk to your doctor today about how to relieve your pain.

Osteoporosis

The term “osteoporosis” comes from the Greek words for “bone” and “porous.” It is a disease characterized by increasing bone loss which can lead to fractures, height loss and a hump-backed appearance. One in two women, and one in five men, over the age of 65 will suffer at least one bone fracture due to osteoporosis.

The most serious risk for people with osteoporosis is hip fracture following a fall. But osteoporotic bones are so weak that it doesn’t always require a fall to cause injury – even everyday activities can result in a fracture. Spinal compression fractures, for example, are the most common osteoporosis-related injury and can be triggered simply by bending over.

A diagnosis of osteoporosis is made after a complete medical history, physical examination and laboratory tests including X-rays and bone densitometry. Other possible causes of bone loss must be ruled out as well. Lost bone cannot be replaced, but your doctor will work with you to prevent further weakening. The treatment plan may include exercise, diet changes, hormone therapy with estrogen (ERT) or anti-estrogens (SERMs), or bone-preserving medications such as Calcitonin or Alendronate.

Risk factors for developing osteoporosis include age and sex (post-menopausal women are at the highest risk), heredity (family history, slender build, fair skin), nutrition, sedentary life, medications (bone thinners, steroids) and illnesses. Everyone reaches a peak bone density at about age 20-25; after age 35, our bones lose mass and weaken unless we take action.

Osteoporosis is not curable, but it is preventable. You can maintain your bones’ health at any age by eating a balanced diet rich in calcium and vitamin D, exercising, not smoking, and limiting alcohol. Regular bone density testing can detect osteoporosis early, before you suffer a fracture.

Sinusitis

Sinusitis is a condition that refers to an inflammation of the lining within the paranasal sinuses. Sinusitis can be classified by location:

  • Maxillary, which causes pain or pressure in the cheek area
  • Frontal, which causes pain or pressure above and behind the eyes
  • Ethmoid, which causes pain or pressure between or behind the eyes
  • Sphenoid, which causes pain or pressure behind the eyes

Sinusitis can also be classified by duration: acute lasts for four weeks or less, subacute lasts four to twelve weeks, chronic lasts more than twelve weeks, and recurrent, which consists of several acute attacks within a year.

Most acute cases of sinusitis are caused by an inflammation of the sinuses that eventually lead to a bacterial infection. With chronic sinusitis, the membranes of both the paranasal sinuses and the nose are thickened because they are constantly inflamed, possibly due to allergies, nasal polyps, or asthma.

Sinusitis can be treated through courses of antibiotics, decongestants, saline sprays, or in cases of severe chronic sinusitis, oral steroids. When pharmaceuticals fail, surgery may be an alternative. The goal of the surgery is to improve sinus drainage and reduce blockage. Thus, a surgeon will enlarge the opening of the sinuses, remove any polyps, and correct any defects that contribute to the nasal obstruction. While many people have fewer symptoms as a result of the surgery, many others experience a recurrence of their symptoms post-surgery.

UTI

A urinary tract infection is a common infection of the urinary system, which includes the kidneys, ureters, bladder and urethra. The urinary tract refers to just the bladder and the urethra, and an infection can develop in either of these areas. These infections occur much more frequently in women than in men and can cause intense pain.

Symptoms of a urinary tract infection include:

  • Burning with urination
  • Strong, constant urge to urinate
  • Blood in the urine
  • Back pain
  • Fever

If you are experiencing symptoms of a urinary tract infection, see your doctor right away. If left untreated, this condition can lead to kidney infections and cause permanent damage to the kidneys. A urinary tract infection can usually be treated with antibiotics.

Weight Gain

Obesity is the leading cause of preventable death worldwide and responsible for over one hundred thousand American deaths each year. The management of one’s weight is becoming more and more medically relevant, as it seems our inability to do so is quietly killing off significant numbers of the population

The majority of weight control methods focus very heavily on calorie intake and expenditure, as the only logical and proven method of weight loss is a negative energy balance between the two. This negative energy balance can be manipulated in many ways, mainly through both diet and exercise.

Dieting

The overall goal of dieting is to decrease the total calorie intake of an individual relative to their current calorie intake. If a person weighs a static 100 kilograms, then that person must be consuming and burning approximately equal values of energy. If one reduces the calories taken in, the balance will result in more calories being removed each day and a gradual, healthy pattern of weight loss can ensue. This subtracts from the proverbial “positive side” of the energy balance.

Many people will argue that their “metabolism will slow down” when they diet to make up for the reduced calories; a completely logical conclusion based on our evolutionary requirement to survive on little food. However, physical activity can greatly aid in controlling one’s basal metabolic rate so as not to be caught up by your own body’s effort to save itself from its perceived starvation.

Exercise

Exercise refers to any physical activity that improves or maintains physical fitness and overall health. Exercise has been strongly correlated with reduced disease affluence, reduced occurrence of obesity and positive psychological well-being. In addition, physical activity can also help reduce the body’s levels of cortisol, a stress hormone that builds fat in the abdominal area. This increases the “negative side” of the energy balance, creating an even greater deficit, and thus loss of stored energy.

The two main categories of exercise are aerobic and anaerobic. Aerobic exercise tends to be longer in duration and focused on cardiovascular endurance, whereas anaerobic exercise consists of short bouts of high intensity activity. It was once believed that aerobics were much more efficient in weight loss than anaerobic, but recent studies have shown anaerobic activity can produce very similar energy expenditures due to elevated post-exercise oxygen consumption (EPOC).

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