QUOTE FOR MONDAY:

Anemia is a condition in which you don’t have enough healthy red blood cells to carry adequate oxygen to the body’s tissues. Having anemia may make you feel tired and weak. There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe.

MAYO Clinic

Part I Anemia

anemia2

Anemia develops when you don’t have enough robust, healthy red blood cells to carry oxygen throughout your body. The blood cells may lack enough hemoglobin, the protein that gives blood its red color. Anemia affects one in 10 teen girls and women. It also develops in men and children and is linked to some illnesses.  Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get enough oxygen. Symptoms of anemia — like fatigue — occur because organs aren’t getting what they need to function properly.

Anemia is the most common blood condition in the U.S. It affects about 3.5 million Americans. Women, young children, and people with chronic diseases are at increased risk of anemia.

There types of different anemia’s but today’s we’ll look more into is Iron deficiency anemia.

Iron deficiency anemia is a common type of anemia — a condition in which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body’s tissues.

As the name implies, iron deficiency anemia is due to insufficient iron. Without enough iron, your body can’t produce enough of a substance in red blood cells that enables them to carry oxygen (hemoglobin). As a result, iron deficiency anemia may leave you tired and short of breath.

You can usually correct iron deficiency anemia with iron supplementation. Sometimes additional tests or treatments for iron deficiency anemia are necessary, especially if your doctor suspects that you’re bleeding internally.

Initially, iron deficiency anemia can be so mild that it goes unnoticed. But as the body becomes more deficient in iron and anemia worsens, the signs and symptoms intensify.

Iron deficiency anemia symptoms may include:

  • Extreme fatigue, Pale skin, Weakness, Shortness of breath, Chest pain, Frequent infections
  • Headache, Dizziness or lightheadedness, Cold hands and feet, Inflammation or soreness of your tongue, Brittle nails, and Fast heartbeat.
  • Unusual cravings for non-nutritive substances, such as ice, dirt or starch.
  • Poor appetite, especially in infants and children with iron deficiency anemia.
  • An uncomfortable tingling or crawling feeling in your legs (restless legs syndrome).

Causes of iron deficiency anemia include:

  • Blood loss. Blood contains iron within red blood cells. So if you lose blood, you lose some iron. Women with heavy periods are at risk of iron deficiency anemia because they lose blood during menstruation. Slow, chronic blood loss within the body — such as from a peptic ulcer, a hiatal hernia, a colon polyp or colorectal cancer — can cause iron deficiency anemia. Gastrointestinal bleeding can result from regular use of some over-the-counter pain relievers, especially aspirin.
  • A lack of iron in your diet. Your body regularly gets iron from the foods you eat. If you consume too little iron, over time your body can become iron deficient. Examples of iron-rich foods include meat, eggs, leafy green vegetables and iron-fortified foods. For proper growth and development, infants and children need iron from their diet, too.
  • An inability to absorb iron. Iron from food is absorbed into your bloodstream in your small intestine. An intestinal disorder, such as celiac disease, which affects your intestine’s ability to absorb nutrients from digested food, can lead to iron deficiency anemia. If part of your small intestine has been bypassed or removed surgically, that may affect your ability to absorb iron and other nutrients.
  • Without iron supplementation, iron deficiency anemia occurs in many pregnant women because their iron stores need to serve their own increased blood volume as well as be a source of hemoglobin for the growing fetus.

 

 

QUOTE FOR THE WEEKEND:

“In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team.”

Cancer.Net (www.cancer.net)

QUOTE FOR FRIDAY:

“According to the American Cancer Society, about 11,280 people will be diagnosed with sarcoma this year and slightly more men than women develop soft tissue sarcoma. Sarcomas are cancers that are much more likely to affect children and young adults than many other more common cancers. Sarcoma is a very rare disease. Due to its rarity, it is crucial for patients to seek a cancer specialist in the treatment of their disease. Sarcoma arises in the connective tissue of the body.”

Rogel Cancer Center Michigan Medicine (www.rogelcancercenter.org)

Gastrointestinal stromal tumor (GIST)

Gastrointestinal stromal tumors (GISTs) are soft-tissue sarcomas that can be located in any part of the digestive system. Their most common sites are the stomach and small intestine.

GISTs start in specialized nerve cells located in the walls of your digestive system. These cells are part of the autonomic nervous system. A specific change in the DNA of one of these cells, which control such digestive processes as movement of food through the intestines, gives rise to a GIST.

Small GISTs may cause no symptoms, and they may grow so slowly that they have no serious effects. People with larger GISTs usually seek medical attention when they vomit blood or pass blood in their stool due to rapid bleeding from the tumor.

Other possible GIST symptoms include:

  • Anemia, caused by a slow-bleeding tumor
  • Abdominal pain
  • A growth you can feel in your abdomen
  • Nausea
  • Vomiting
  • Loss of appetite
  • Weight loss
  • Difficulty swallowing

GISTs can develop in people of all ages, but they are most common between age 50 and 70, and they almost never occur before age 40. In rare cases, an inherited genetic change (mutation) causes GISTs.

Diagnosis

After asking questions about your symptoms and medical history, your doctor will examine you carefully, checking for a growth in your abdomen. If signs and symptoms suggest you may have a GIST, tests to locate it and then determine its likelihood of spreading (metastasizing) to other organs will follow. These tests may include:

    • Contrast-enhanced computerized tomography (CT) scan. For this test, you swallow a liquid that makes your stomach and small intestine more visible on X-rays. You may also receive an injection of a similar substance. Then the scanner takes numerous X-rays as it moves over your abdomen. A computer combines the X-rays into detailed, cross-sectional images of your abdominal organs, showing the size and position of the tumor.
    • Upper endoscopy. The doctor examines the inner lining of the esophagus, stomach and the first part of the small intestine with a flexible, lighted tube (endoscope) passed down through your mouth. It may be possible to take small samples of abnormal tissue during an upper endoscopy. During this test, you’ll receive a mild relaxing medication (sedative) through an intravenous line.
    • Endoscopic ultrasound (EUS). This test also uses an endoscope, but with an ultrasound probe on the tip of the scope. As sound waves from the probe create echoes that bounce back to the probe, a computer translates the echoes into an image of the structures in the abdomen, showing the precise location of the tumor. If the tumor has metastasized to your liver or the lining of your abdomen, these areas may also be visible. An EUS also helps determine the depth of the tumor within the wall of the stomach or other locations in the gastrointestinal tract.
    • Fine-needle aspiration biopsy. A small sample of tissue from the tumor is necessary for a definite GIST diagnosis. The preferred method for taking a biopsy sample is endoscopic ultrasound with fine-needle aspiration. This procedure is the same as an EUS, but with a thin, hollow needle on the tip of the endoscope. The needle is used to remove small amounts of tissue for laboratory analysis.

Sometimes these tests aren’t possible, or their results are inconclusive, so a suspected GIST can’t be located without surgery. Tissue analysis then takes place after the tumor is removed.

  • Laboratory tests on biopsies. These tests provide information on the proteins tumor cells make. One of these tests, immunohistochemistry, detects specific proteins controlled by genes in GIST cells. Identification of these proteins helps guide treatment decisions. Sometimes, actual genetic testing of biopsy samples is necessary to locate GIST genes in tumor DNA. GIST cells are also examined under a microscope to see how many cells out of 50 different microscopic fields are actively dividing. This number is known as the mitotic rate. The higher the mitotic rate in a tumor, the more aggressive it is, and the greater is its likelihood of spreading to other organs.

Treatment

Small, asymptomatic GISTs found in the course of tests for another condition may be approached with watchful waiting in carefully selected cases.

Surgery

All large or symptomatic GISTs should be surgically removed unless they are too large or they involve too many organs and tissues for surgery (resection). Resection is also delayed or avoided in people whose general health makes any surgery too risky to undertake, as well as those likely to have metastatic GISTs.

It’s often possible to resect GISTs using minimally invasive surgery, which involves inserting a viewing tube (laparoscope) and surgical instruments through small incisions in the abdomen.

Targeted drug therapy

GISTs do not respond to traditional chemotherapy. Thanks to recently gained understanding of tumor genetic changes in GISTs, however, drugs that interrupt the process of tumor spread have greatly improved the outlook for people with the disease.

Imatinib (Gleevec) is the first line medical treatment used to prevent GIST recurrence after surgery. The drug is also used in situations where surgery isn’t possible, as well as in controlling recurrent GIST.

The current trend is to continue imatinib treatment as long as it’s tolerated and it remains effective. Unfortunately, GISTs tend to become resistant to imatinib over time. A different targeted drug, sunitinib malate (Sutent) often works on imatinib-resistant GISTs. A number of other targeted drugs now in development are expected to join imatinib and sunitinib in coming years.

QUOTE FOR WEDNESDAY:

“Each year in the U.S., thousands of babies are born with a cleft, occurring when tissue in the baby’s upper lip or roof of the mouth does not join together completely during pregnancy. July has been proclaimed Cleft and Craniofacial Awareness Month in the town of Chapel Hill and the state of North Carolina, and the American Cleft Palate-Craniofacial Association (ACPA) is raising awareness about the condition – and the countless individuals living with a facial difference nationwide – by hosting several special events throughout the month.”

American Cleft Palate Cranio-facial Association

QUOTE FOR TUESDAY:

“Summer days are the time for sharing food with family at barbecues and picnics. However, warm weather also encourages bacteria to grow. The CDC recommends that pre-prepared food be sealed and kept cool if possible. If you’ve come down with a case of food poisoning, make sure that you drink lots of fluids and rest.”

Center for Disease Control and Prevention

QUOTE FOR MONDAY:

“Alarm Symptoms :

Certain alarm symptoms may point to complications or life-threatening problems. Should you have any of these alarm-warning symptoms, talk to your doctor right away.

  • Chest pain with activity, such as climbing stairs.
  • Losing weight without trying.
  • Choking while eating or trouble swallowing food and liquids.
  • Throwing up blood or material that looks like coffee grounds.
  • Red or black stools.”

American Gastroenterological Association (aga)www.gastro.org

 

QUOTE FOR THE WEEKEND:

Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. Many people, including pregnant women, suffer from heartburn or acid indigestion caused by GERD.

American Gastroenterological Association (aga)-www.gastro.org

Part I ACID REFLUX

 

How to stay healthy with acid reflux?  A GI disease that is caused by a valve located between the esophagus and stomach, which normally is a strong muscular ring of tissue.  This valve normally opens and closes completely preventing food backing up (called reflux) in the esophagus allowing the contents to reach the throat to the mouth.  With acid reflux, what happens is this valve gets over expanded frequently to the point the valve gets overstretched and no longer fits over the opening between the esophagus and the stomach with a tight fit.  Due to loss of the elasticity it now is allowing leakage from the stomach with both food and fluids going up the esophagus to the throat to the mouth due to the action of reflux, during the digestion process.  What happens during digestion the stomach contents with digestive fluids (which are acidic) are refluxed, that are not normally in the esophagus. In conclusion, reflux sends stomach contents that’s returning (an acidic environment) upward in the esophagus which is now in an environment not use to being exposed to the digestive fluids =acidity, which are needed to perform the digestion process of our foods/fluids that are in the stomach only.   This leakage of the valve is the cause of this problem occurring=GERD or gastrointestinal reflux.

When you don’t have GERD food and fluids when swallowed go down the esophagus to the valve where it opens letting the contents into the stomach, where digestion takes place in about 1-2 hours after eating. Normally the valve is tight enough in preventing reflux=no leakage (the primary purpose of its function).  This means during digestion the food gets into the stomach which is broken down into smaller particles by the digestive acid fluids allowing the nutrients to pass into the bloodstream with the waste products staying in the stomach but when stomach digestion is complete it passes all the waste products onto the smaller intestines to the larger intestines to the rectum to be evacuated, without leakage or reflux.

The signs and symptoms (s/s) of GERD or acid reflux:

1-Heartburn is the classic GERD symptom. It’s best described as a burning sensation in the chest and/or discomfort in the upper belly or abdomen accompanied by a feeling of fullness.  

2- Regurgitation is the involuntary return of partially digested food from the stomach into the mouth.  This uncomfortable symptom is commonly caused by GERD, since the esophageal sphincter (valve) is damaged to such a severe degree that the stomach juices (acidotic) can freely reflux to the level of the throat or mouth.

3-Pain present behind the sternum (chest pain) to the upper mid abdomen (where the stomach is).  If severe call your M.D. or doctor to have evaluated  (especially if in the chest).

4-Chronic cough to hoarseness  5-Recurrent pneumonias  6-Bloating 7-Nausea 8-Vomiting (yellow/green) 9-Lump in the throat 10-Difficulty swallowing 11-Chronic sore throat 12-Laryngitis 13-Post nasal drip 14-Ear Aches 15-Tooth decay or gingivitis (inflammation of the gums) or bad breath this is due to the acid fluids with the foods and fluids regurgitated back to the mouth from the stomach.

Complications that are caused by GERD when left untreated:

1-Narrowing of the esophagus called esophageal stricture.  This is due to damage to cells in the lower esophageal from acid exposure that leads to scarring of the tissue.  The scar tissue narrows the food pathway causing difficulty to  swallow called dysphagia.    2-Esophagitis – inflammation of the esophagus.  This constant backwash of acid can irritate the lining of your esophagus. Over time, the inflammation can cause complications such as bleeding or breathing problems leading into esophagitis.

3-Esophageal Ulcers – Due to frequent exposure to acidic fluids and foods to the esophagus the mucosa gets irritated so bad it will even erode the mucosa causing skin ulceration.  The esophagus environment is not use to the stomach’s = acidic.  Take the outer skin of the body, if exposed long enough to acidic chemicals the skin will burn.  Same principle for the esophagus constantly  exposed to the environment of the stomach’s content of acidic fluids every time digestion takes place.

4-Precancerous changes to the esophagus (Barrett’s esophagus).  In Barrett’s esophagus, the color and composition of the tissue lining the lower esophagus change.  These changes are associated with risk of esophageal cancer.  The risk of cancer is low.  Cancer is rare but can happen (adenocarcinoma of the esophagus).

Risk factors=Conditions that increase the risk of GERD would include:   Obesity, Pregnancy, Smoking, Dry Mouth, Diabetes, Asthma, Connective Tissue Disorders like scleroderma, delayed stomach empting, Zollinger-Ellison syndrome (ZES)

(This is a rare disorder characterized by one or more tumors in the pancreas, duodenum, or both. The tumors cause the stomach to make too much acid, leading to peptic ulcers in the duodenum. The tumors are sometimes cancerous and spread to other areas of the body.).

The key to treatment is prevention but if already with the Dx: GERD than it would be maintenance.  There is no one answer but start with being checked by your physician if you have any symptoms indicative of this diagnosis.  Start with a getting a very good diagnostic tool ordered by your doctor called an Upper GI series (endoscopy) and when it’s done it will tell the M.D. a lot in what’s going on.  Then there is medications as a remedy, that can be useful, they are classified as proton pump inhibitors to H2 Inhibitors with more.  Another great key to the treatment is your LIFESTYLE=Diet (not eating acid foods, not eating fast), activity/exercise, your height compared to your weight (BMI or simply what you weigh) and lastly if you practice healthy vs. unhealthy habits.  If you would like to learn more about this come back tomorrow to my web page when I go further on the topic GERD (part 2) regarding the diet for the disease.