“Gastroparesis is a condition that affects the normal spontaneous movement of the muscles (motility) in your stomach. Ordinarily, strong muscular contractions propel food through your digestive tract. But if you have gastroparesis, your stomach’s motility is slowed down or doesn’t work at all, preventing your stomach from emptying properly.”
MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/)
Should focus attention on important health messages about gastroparesis diagnosis, treatment, and quality of life issues. The goals include improving understanding of gastroparesis to help patients and families manage the condition, and encouraging preventive strategies.
The number of people with gastroparesis appears to be rising. Yet gastroparesis is poorly understood. More community awareness is needed about the condition.
The more awareness for gastroparesis, the greater the ability to impact positive outcomes, such as additional research and improved patient care for the functional GI and motility disorders.
Gastroparesis is also called delayed gastric emptying. The term “gastric” refers to the stomach.
Normally, the stomach empties its contents in a controlled manner into the small intestines. In gastroparesis, the muscle contractions (motility) that move food along the digestive tract do not work properly and the stomach empties too slowly.
Gastroparesis is characterized by the presence of certain long-term symptoms together with delayed stomach emptying in the absence of any observable obstruction or blockage. The delayed stomach emptying is confirmed by a test.
The signs and symptoms of gastroparesis may differ among persons with the condition. Symptoms usually occur during and after eating a meal.
Symptoms that are characteristic of gastroparesis include:
The symptoms of gastroparesis are similar to those that occur in a number of other illnesses. When symptoms persist over time or keep coming back, it’s time to see a doctor to diagnose the problem. An accurate diagnosis is the starting point for effective treatment.
Diagnosis of gastroparesis begins with a doctor asking about symptoms and past medical and health experiences (history), and then performing a physical exam. Any medications that are being taken need to be disclosed.
Tests will likely be performed as part of the examination. These help to identify or rule out other conditions that might be causing symptoms. Tests also check for anything that may be blocking or obstructing stomach emptying. Examples of these tests include:
If – after review of the symptoms, history, and examination – the doctor suspects gastroparesis, a test to measure how fast the stomach empties is required to confirm the diagnosis.
Slow gastric emptying alone does not correlate directly with a diagnosis of gastroparesis.
There are several different ways to measure the time it takes for food to empty from the stomach into the small intestine. These include scintigraphy, wireless motility capsule, or breath test. Your doctor will provide details of the one chosen.
Gastric Emptying Study (Scintigraphy)
The diagnostic test of choice for gastroparesis is a gastric emptying study (scintigraphy). The test is done in a hospital or specialty center.
It involves eating a bland meal of solid food that contains a small amount of radioative material so that it can be tracked inside the body. The abdomen is scanned over the next few hours to see how quickly the meal passes out of the stomach. A radiologist will interpret the study at periodic intervals after the meal.
A diagnosis of gastroparesis is confirmed when 10% or more of the meal is still in the stomach after 4 hours.
Other methods for measuring gastric emptying include a wireless motility capsule and a breath test.
Wireless Motility Capsule
The ingestible wireless motility capsule (SmartPill) is swallowed and transmits data to a small receiver that the patient carries. The data collected is interpreted by a radiologist. While taking the test, people can go about their daily routine. After a day or two, the disposable capsule is excreted naturally from the body.
Breath Test
The breath test involves eating a meal that contains a nonradioactive component that can be tracked and measured in the breath over a period of hours. The results can then be calculated to determine how quickly the stomach empties.
Stay tune for Part II tomorrow!
“Stevens Johnson Syndrome (SJS) is a life-threatening skin condition in which the loss of skin
cells triggers the epidermis to separate from the dermis. The majority of diagnoses are idiopathic and have no known cause.
Whereas, the principal source of SJS is linked to the adverse effects of certain medications (for some causing a challenge) which can cause ulcers and lesions in the mucous membranes, conjunctivitis, blindness, organ failure, and death.
In the United States, 300 new cases of SJS appear every year. Adult women are twice likely as men to contract the disease.”
Forrest Warren Human Services
(478-Stevens-Johnson-Syndrome-Awareness–Month-PDF)
The Facts About Stevens-Johnson Syndrome (SJS/TEN) as of 2023 through Stevens-Johnson Syndrome Foundation state the following:
“FIRST What is this condition SJS – Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe adverse reactions to medication and, in some instances, viruses and mycoplasma pneumonia.
According to the FDA, adverse drug reactions (ADRs) account for 2,216,000 hospitalizations each year that result in injury or death.
SJS is one of the most debilitating ADR’s recognized. It was first discovered in 1922 by pediatricians Albert Stevens and Frank Johnson after diagnosing two children with severe ocular and oral involvement due to drug reactions
Recognition of the early symptoms of SJS and prompt medical attention are the most invaluable tools in minimizing the possible long-term effects of SJS.
-Rash, blisters or red splotches on skin
-Persistent fever
-Blisters in mouth, eyes, ears, nose or genital area
-Swelling of eyelids, red eyes, Conjuctivitis
-Flu-like symptoms
*Have recently taken a prescription or over-the counter (OTC) medication
Target lesions are not always seen in SJS/TEN!
IF YOU NOTICE TWO OR MORE OF THESE SYMPTOMS,
CONTACT A PHYSICIAN IMMEDIATELY!
The offending drug must be stopped immediately to prevent
complications.
Supportive care.
IV fluids and high-calorie formulas are given to promote
healing.
Antibiotics are given when necessary to prevent secondary
infections.
Pain medications are given for comfort.
Most SJS patients are treated in ICU, but TEN patients
should be treated in a burn unit.
Treatments can include the following medications:
-pulse steroids,
-Immunoglobulin (IVIG),
and Cyclosporine therapies.
The doctors to see for this condition:
Dermatologists, ophthalmologists and infectious disease doctors should be consulted.
If ocular involvement occurs, amniotic membrane grafts in the first 3 to 5 days of diagnosis may prevent serious eye damage
-Blindness or Visual impairment
-Photophobia
-Dry eye syndrome
-Lung damage including Asthma
and Chronic Obstructive Pulmonary Disease (COPD)
-Permanent loss of nail beds
-Scarring and hyperpigmentation
-Alopecia
-Arthritis
-Chronic fatigue
These are some of the side effects reported to the Stevens Johnson Syndrome Foundation through their SJS registry fact sheet in 2023.
** Almost any DRUG can cause SJS/TEN, including over-the-counter drugs. SJS and TEN do not discriminate against anyone! Everyone should be aware of adverse drug reactions.
“A new report authored by volunteer researchers and staff of the National Center for Children’s Vision and Eye Health at Prevent Blindness (NCCVEH), titled “Association of Sociodemographic Characteristics with Pediatric Vision Screening and Eye Care: An Analysis of the 2021 National Survey of Children’s Health” in Ophthalmology, found that only 53 percent of U.S. children received a vision screening in 2021. This disparity is even more pronounced among children from disadvantaged backgrounds.
Without early detection and treatment, uncorrected vision disorders can impair healthy development, interfere with learning, and even lead to permanent vision loss. However, vision screening and regular eye care can help detect and treat potentially irreversible vision impairment. Visual functioning is a strong predictor of academic performance in school-age children.”
Prevent Blindness (Prevent Blindness Expresses Concern Over Medicaid Community Engagement and Eligibility Requirements for Visually Impaired – Prevent Blindness)
If you suffer from itchy, red and dry skin you’ve probably tried every cream, ointment and lotion on the market to treat your eczema. But if you’ve tried it all and can’t seem to calm your itchy skin it might be because there’s another skin condition that can have visually similar symptoms and your eczema cream probably won’t work for it. It’s called psoriasis.
Eczema and psoriasis are like twins — they have a similar look, but deep down, they are fundamentally different.
If you suffer from itchy, red and dry skin you’ve probably tried every cream, ointment and lotion on the market to treat your eczema. But if you’ve tried it all and can’t seem to calm your itchy skin it might be because there’s another skin condition that can have visually similar symptoms and your eczema cream probably won’t work for it. It’s called psoriasis.
Eczema and psoriasis are like twins — they have a similar look, but deep down, they are fundamentally different!
You might be thinking: When you’ve got an irritating, itchy spot, who cares about the subtle difference? But this can help you and your dermatologist decide which skin condition you are having.
Dr. Millstein, a physician at Penn Internal Medicine Woodbury Heights, says “Psoriasis tends to cause milder itching and, in some less common types of psoriasis, a terrible burn. Eczema, on the other hand, can lead to very intense itching. When it starts to become severe, some people scratch their skin so hard that it bleeds.”
Both skin diseases can show up anywhere on your body, but they have their own favorite areas.
Psoriasis causes troubles commonly on the:
Eczema can occur in those places, but it most often inflames the skin on the back of the knees or the inside of the elbows.
Although you can get either disease at any age, eczema often affects children while psoriasis usually manifests in early adulthood or later.
If you have eczema, summer might not be your favorite season. Some people with eczema are sensitive to heat. In hot weather, overheating can cause perspiration, which can lead to skin flare.
“However, for most psoriasis patients, abundant natural ultraviolet B (UVB) light from sunshine can be a blessing. UVB light can slow down the abnormal growth of skin cells. It is used as a medical treatment for psoriasis,” says Dr. Millstein.
But remember, too much of a good thing can become damaging. If you go sunbathing without using sunscreen or are exposed to sunlight for too long, overexposure can trigger psoriasis symptoms. If you start to feel itchy or see red spots, get out of the sun. Make sure to talk to your dermatologist about the best amount of time for exposure to the sun.
If you have itchy, red patches on any part of your body that don’t go away with over-the-counter medications, it’s better to see a dermatologist directly. Primary care providers can also help make a diagnosis and manage your symptoms, but a dermatologist has specialized training and extensive experience in recognizing subtleties of the two skin conditions.
The treatments for eczema and psoriasis are similar. Some of the common treatments include:
Eczema and psoriasis can present very differently in each person. Comparing your symptoms to another patient’s won’t always give you the right answer or the best solution for another.
In severe cases, psoriasis can turn into psoriatic arthritis. When this is the case, a medicine such as methotrexate or cyclosporine may be recommended by a doctor to help manage symptoms. Be sure to ask about all potential ointments and creams available to help your skin rashes.
(updated 5/12/24)
“Millions of people in the U.S. and around the world experience psoriasis and psoriatic arthritis, and there is no cure, yet.
Psoriasis can appear at any age, but often has two peaks of onset. The first is between 20 – 30 years of age and the second between 50 – 60 years of age. [11]
Psoriatic arthritis usually develops between the ages of 30 and 50, but can develop at any age.
The National Psoriasis Foundation defines mild psoriasis as affecting less than 3 percent of the body; 3 percent to 10 percent is considered moderate; more than 10 percent is considered severe. For most individuals, your hand is about the same as 1 percent of the skin surface.
However, the severity of psoriasis is also measured by how psoriasis affects a person’s quality of life. Nearly one-quarter of people with psoriasis have cases that are considered moderate to severe.”
The National Psoriasis Foundation (https://www.psoriasis.org/psoriasis-statistics/)
If you suspect that you may have psoriasis, see your doctor for an examination. Also, talk to your doctor if your psoriasis:
Seek medical advice if your signs and symptoms worsen or don’t improve with treatment. You may need a different medication or a combination of treatments to manage the psoriasis.
The cause of psoriasis isn’t fully understood, but it’s thought to be related to an immune system problem with T cells and other white blood cells, called neutrophils, in your body.
T cells normally travel through the body to defend against foreign substances, such as viruses or bacteria.
But if you have psoriasis, the T cells attack healthy skin cells by mistake, as if to heal a wound or to fight an infection.
Overactive T cells also trigger increased production of healthy skin cells, more T cells and other white blood cells, especially neutrophils. These travel into the skin causing redness and sometimes pus in pustular lesions. Dilated blood vessels in psoriasis-affected areas create warmth and redness in the skin lesions.
The process becomes an ongoing cycle in which new skin cells move to the outermost layer of skin too quickly — in days rather than weeks. Skin cells build up in thick, scaly patches on the skin’s surface, continuing until treatment stops the cycle.
Just what causes T cells to malfunction in people with psoriasis isn’t entirely clear. Researchers believe both genetics and environmental factors play a role.
Psoriasis typically starts or worsens because of a trigger that you may be able to identify and avoid. Factors that may trigger psoriasis include:
Anyone can develop psoriasis, but these factors can increase your risk of developing the disease:
If you have psoriasis, you’re at greater risk of developing certain diseases. These include:
“Acute and chronic liver failure happen in different ways, but they’re both due to overwhelming stress on your liver. “Liver disease” is a broad term for any condition that damages your liver and affects how it works. Some of the conditions are common, while others aren’t. They can all range from mild to life-threatening. Some types develop slowly over time, while others happen more quickly.
Your liver plays an important role in your body. It helps clean your blood, process nutrients and fight off infections. When it’s damaged, it can’t perform these jobs well. Over time, liver disease can lead to many dangerous conditions!”
Cleveland Clinic (Liver Disease: Symptoms, Causes, Stages & Treatment)
The liver is an organ about the size of a football. It sits just under your rib cage on the right side of your abdomen. The liver is essential for digesting food and ridding your body of toxic substances.
In America, liver disease affects millions and is on the rise. Did you know there are more than 100 different types of liver disease? Living with long-term, chronic liver disease can cause damage to your liver.
Most liver diseases damage your liver in similar ways and for many, the progression of liver disease looks the same regardless of the underlying disease.
Early diagnosis may prevent damage from occurring in your liver. Your liver is an incredible organ. If you’re diagnosed when some scar tissue has already formed, your liver can repair and even regenerate itself. Because of this, damage from liver disease can often be reversed with a well-managed treatment plan.
Many people with liver disease do not look or feel sick even though damage is happening to their liver. At a certain point in the progression of liver disease damage can become irreversible and lead to liver failure, liver cancer, or death.
Inflammation is the body’s natural response to injury and an important part of healing or immune response. Think about when you get a cut or injury to your skin. The area around the wound becomes swollen or inflamed. Seeing the swelling is not the only way you experience the inflammatory phase. You may also experience pain, redness, or the wound may feel warm to the touch. Under the skin, your body is hard at work to stop the bleeding and prevent infection. Blood vessels near the wound widen, or dilate, making more room for special healing and repair cells, or cells in the wounded area. These cells remove damaged cells and harmful substances (like bacteria or viruses) and allow the rest of the healing process to continue. Inflammation is essential to fight infection.
While this controlled inflammation is essential to maintain proper function and balance in the liver, if it becomes dysregulated it drives the progression of liver disease. This diseased inflammation is called hepatitis. We most often hear the word hepatitis when we talk about viral hepatitis, like hepatitis A, B, or C, but viruses are not the only cause of hepatitis.
Infection with a virus, overindulging in alcohol or fatty foods, or even our own immune system can trigger a continual inflammatory response in the liver, disrupting the closely regulated cycle of inflammation and healing. When someone has liver disease, their liver enters into a very dangerous cycle. Persistent inflammation sends nonstop signals to the repair cells to continue depositing collagen. The extra collagen stiffens around the tissue like it is supposed to in the healthy liver but, instead of a signal being released to stop the inflammation and discard the extra collagen, the inflammation continues and even more collagen is deposited leading to more stiffening. This is how scars or fibroids, develop in the liver. If left untreated, the scars will continue to replace healthy liver cells, leading to severe scarring known as cirrhosis.
It’s important to speak to your doctor about any possible risk factors for hepatitis or if you’ve experienced symptoms. There are many different causes for hepatitis with varying risks and symptoms.