CEN

CEN Migraine Headache Overview

A migraine can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities. For some people, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg and difficulty speaking. Medications can help prevent some migraines and make them less painful. The right medicines, combined with self-help remedies and lifestyle changes, might help.

Signs and Symptoms

Migraines, which often begin in childhood, adolescence or early adulthood, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.

Causes

Though migraine causes aren't fully understood, genetics and environmental factors appear to play a role. Changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway, might be involved. So might imbalances in brain chemicals — including serotonin, which helps regulate pain in your nervous system. Researchers are studying the role of serotonin in migraines. Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).

Risk Factors

Several factors make you more prone to having migraines, including:

• Family history. If you have a family member with migraines, then you have a good chance of developing them too.
• Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.
• Sex. Women are three times more likely to have migraines.
• Hormonal changes. For women who have migraines, headaches might begin just before or shortly after onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.

Complications

Taking combination painkillers, such as Excedrin Migraine for more than 10 days a month for three months or in higher doses can trigger serious medication-overuse headaches. The same is true if you take aspirin or ibuprofen (Advil, Motrin IB, others) for more than 15 days a month or triptans, sumatriptan (Imitrex, Tosymra) or rizatriptan (Maxalt), for more than nine days a month. Medication-overuse headaches occur when medications stop relieving pain and begin to cause headaches. You then use more pain medication, which continues the cycle.

Treatment

Migraine treatment is aimed at stopping symptoms and preventing future attacks. Many medications have been designed to treat migraines. Medications used to combat migraines fall into two broad categories:

• Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
• Preventive medications. These types of drugs are taken regularly, often daily, to reduce the severity or frequency of migraines.

 

CEN Appendicitis Overview

Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from your colon on the lower right side of your abdomen. Appendicitis causes pain in your lower right abdomen. However, in most people, pain begins around the navel and then moves. As inflammation worsens, appendicitis pain typically increases and eventually becomes severe. Although anyone can develop appendicitis, most often it occurs in people between the ages of 10 and 30. Standard treatment is surgical removal of the appendix.

Signs and Symptoms

• Sudden pain that begins on the right side of the lower abdomen
• Sudden pain that begins around your navel and often shifts to your lower right abdomen
• Pain that worsens if you cough, walk or make other jarring movements
• Nausea and vomiting
• Loss of appetite
• Low-grade fever that may worsen as the illness progresses
• Constipation or diarrhea
• Abdominal bloating
• Flatulence

Causes

A blockage in the lining of the appendix that results in infection is the likely cause of appendicitis. The bacteria multiply rapidly, causing the appendix to become inflamed, swollen and filled with pus. If not treated promptly, the appendix can rupture.

Complications

• A ruptured appendix. A rupture spreads infection throughout your abdomen (peritonitis). Possibly life-threatening, this condition requires immediate surgery to remove the appendix and clean your abdominal cavity.
• A pocket of pus that forms in the abdomen. If your appendix bursts, you may develop a pocket of infection (abscess). In most cases, a surgeon drains the abscess by placing a tube through your abdominal wall into the abscess. The tube is left in place for about two weeks, and you're given antibiotics to clear the infection.Once the infection is clear, you'll have surgery to remove the appendix. In some cases, the abscess is drained, and the appendix is removed immediately.

Treatment

Appendicitis treatment usually involves surgery (appendectomy) to remove the inflamed appendix. Before surgery you may be given a dose of antibiotics to treat infection.  

CEN Guillain Barre Syndrome Overview

Guillain-Barre syndrome is a rare disorder in which your body's immune system attacks your nerves. Weakness and tingling in your extremities are usually the first symptoms. These sensations can quickly spread, eventually paralyzing your whole body. In its most severe form Guillain-Barre syndrome is a medical emergency. Most people with the condition must be hospitalized to receive treatment. The exact cause of Guillain-Barre syndrome is unknown. But two-thirds of patients report symptoms of an infection in the six weeks preceding. These include respiratory or a gastrointestinal infection or Zika virus. There's no known cure for Guillain-Barre syndrome, but several treatments can ease symptoms and reduce the duration of the illness. Although most people recover from Guillain-Barre syndrome, the mortality rate is 4% to 7%. Between 60-80% of people are able to walk at six months. Patients may experience lingering effects from it, such as weakness, numbness or fatigue.

Signs and Symptoms

Guillain-Barre syndrome often begins with tingling and weakness starting in your feet and legs and spreading to your upper body and arms. In about 10% of people with the disorder, symptoms begin in the arms or face. As Guillain-Barre syndrome progresses, muscle weakness can evolve into paralysis. Signs and symptoms of Guillain-Barre syndrome may include:

• Prickling, pins and needles sensations in your fingers, toes, ankles or wrists
• Weakness in your legs that spreads to your upper body
• Unsteady walking or inability to walk or climb stairs
• Difficulty with facial movements, including speaking, chewing or swallowing
• Double vision or inability to move eyes
• Severe pain that may feel achy, shooting or cramplike and may be worse at night
• Difficulty with bladder control or bowel function
• Rapid heart rate
• Low or high blood pressure
• Difficulty breathing

Causes

The exact cause of Guillain-Barre syndrome isn't known. The disorder usually appears days or weeks after a respiratory or digestive tract infection. Rarely, recent surgery or vaccination can trigger Guillain-Barre syndrome. Recently, there have been cases reported following infection with the Zika virus. In Guillain-Barre syndrome, your immune system — which usually attacks only invading organisms — begins attacking the nerves. In AIDP, the most common form of Guillain-Barre syndrome in the U.S., the nerves' protective covering (myelin sheath) is damaged. The damage prevents nerves from transmitting signals to your brain, causing weakness, numbness or paralysis.

Risk Factors

Guillain-Barre syndrome can affect all age groups. But your risk increases as you age. It's also more common in males than females. Guillain-Barre syndrome may be triggered by:

• Most commonly, infection with campylobacter, a type of bacteria often found in undercooked poultry
• Influenza virus
• Cytomegalovirus
• Epstein-Barr virus
• Zika virus
• Hepatitis A, B, C and E
• HIV, the virus that causes AIDS
• Mycoplasma pneumonia
• Surgery
• Trauma
• Hodgkin's lymphoma
• Rarely, influenza vaccinations or childhood vaccinations

Complications

Guillain-Barre syndrome affects your nerves. Because nerves control your movements and body functions, people with Guillain-Barre may experience:

• Breathing difficulties. The weakness or paralysis can spread to the muscles that control your breathing, a potentially fatal complication. Up to 22% of people with Guillain-Barre syndrome need temporary help from a machine to breathe within the first week when they're hospitalized for treatment.
• Residual numbness or other sensations. Most people with Guillain-Barre syndrome recover completely or have only minor, residual weakness, numbness or tingling.
• Heart and blood pressure problems. Blood pressure fluctuations and irregular heart rhythms (cardiac arrhythmias) are common side effects of Guillain-Barre syndrome.
• Pain. One-third of people with Guillain-Barre syndrome experience severe nerve pain, which may be eased with medication.
• Bowel and bladder function problems. Sluggish bowel function and urine retention may result from Guillain-Barre syndrome.
• Blood clots. People who are immobile due to Guillain-Barre syndrome are at risk of developing blood clots. Until you're able to walk independently, taking blood thinners and wearing support stockings may be recommended.
• Pressure sores. Being immobile also puts you at risk of developing bedsores (pressure sores). Frequent repositioning may help avoid this problem.
• Relapse. From 2% to 5% of people with Guillain-Barre syndrome experience a relapse.

Treatment

There's no cure for Guillain-Barre syndrome. But two types of treatments can speed recovery and reduce the severity of the illness:

• Plasma exchange (plasmapheresis). The liquid portion of part of your blood (plasma) is removed and separated from your blood cells. The blood cells are then put back into your body, which manufactures more plasma to make up for what was removed. Plasmapheresis may work by ridding plasma of certain antibodies that contribute to the immune system's attack on the peripheral nerves.
• Immunoglobulin therapy. Immunoglobulin containing healthy antibodies from blood donors is given through a vein (intravenously). High doses of immunoglobulin can block the damaging antibodies that may contribute to Guillain-Barre syndrome.

 

CEN Multiple Sclerosis Overview

Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system). In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause permanent damage or deterioration of the nerves. Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms. There's no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms.

Signs and Symptoms

Multiple sclerosis signs and symptoms may differ greatly from person to person and over the course of the disease depending on the location of affected nerve fibers. Symptoms often affect movement, such as:

• Numbness or weakness in one or more limbs that typically occurs on one side of your body at a time, or your legs and trunk
• Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign)
• Tremor, lack of coordination or unsteady gait

Vision problems are also common, including:

• Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement
• Prolonged double vision
• Blurry vision

Multiple sclerosis symptoms may also include:

• Slurred speech
• Fatigue
• Dizziness
• Tingling or pain in parts of your body
• Problems with sexual, bowel and bladder function

Causes

The cause of multiple sclerosis is unknown. It's considered an autoimmune disease in which the body's immune system attacks its own tissues. In the case of MS, this immune system malfunction destroys the fatty substance that coats and protects nerve fibers in the brain and spinal cord (myelin). Myelin can be compared to the insulation coating on electrical wires. When the protective myelin is damaged and the nerve fiber is exposed, the messages that travel along that nerve fiber may be slowed or blocked. It isn't clear why MS develops in some people and not others. A combination of genetics and environmental factors appears to be responsible.

Risk Factors

• Age. MS can occur at any age, but onset usually occurs around 20 and 40 years of age. However, younger and older people can be affected.
• Sex. Women are more than two to three times as likely as men are to have relapsing-remitting MS.
• Family history. If one of your parents or siblings has had MS, you are at higher risk of developing the disease.
• Certain infections. A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis.
• Race. White people, particularly those of Northern European descent, are at highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk.
• Climate. MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe.
• Vitamin D. Having low levels of vitamin D and low exposure to sunlight is associated with a greater risk of MS.
• Certain autoimmune diseases. You have a slightly higher risk of developing MS if you have other autoimmune disorders such as thyroid disease, pernicious anemia, psoriasis, type 1 diabetes or inflammatory bowel disease.
• Smoking. Smokers who experience an initial event of symptoms that may signal MS are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS.

Complications

• Muscle stiffness or spasms
• Paralysis, typically in the legs
• Problems with bladder, bowel or sexual function
• Mental changes, such as forgetfulness or mood swings
• Depression
• Epilepsy

Treatment

There is no cure for multiple sclerosis. Treatment typically focuses on speeding recovery from attacks, slowing the progression of the disease and managing MS symptoms. Some people have such mild symptoms that no treatment is necessary.  

CEN Dementia Overview

Dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life. It isn't a specific disease, but several different diseases may cause dementia. Though dementia generally involves memory loss, memory loss has different causes. Having memory loss alone doesn't mean you have dementia. Alzheimer's disease is the most common cause of a progressive dementia in older adults, but there are a number of causes of dementia. Depending on the cause, some dementia symptoms may be reversible.

Signs and Symptoms

Cognitive changes

• Memory loss, which is usually noticed by a spouse or someone else
• Difficulty communicating or finding words
• Difficulty with visual and spatial abilities, such as getting lost while driving
• Difficulty reasoning or problem-solving
• Difficulty handling complex tasks
• Difficulty with planning and organizing
• Difficulty with coordination and motor functions
• Confusion and disorientation

Psychological changes

• Personality changes
• Depression
• Anxiety
• Inappropriate behavior
• Paranoia
• Agitation
• Hallucinations

Causes

Dementia is caused by damage to or loss of nerve cells and their connections in the brain. Depending on the area of the brain that's affected by the damage, dementia can affect people differently and cause different symptoms. Dementias are often grouped by what they have in common, such as the protein or proteins deposited in the brain or the part of the brain that's affected. Some diseases look like dementias, such as those caused by a reaction to medications or vitamin deficiencies, and they might improve with treatment.

Risk Factors

Risk factors that can't be changed

• Age. The risk rises as you age, especially after age 65. However, dementia isn't a normal part of aging, and dementia can occur in younger people.
• Family history. Having a family history of dementia puts you at greater risk of developing the condition. However, many people with a family history never develop symptoms, and many people without a family history do. There are tests to determine whether you have certain genetic mutations.
• Down syndrome. By middle age, many people with Down syndrome develop early-onset Alzheimer's disease.

Risk factors you can change You might be able to control the following risk factors for dementia.

• Diet and exercise. Research shows that lack of exercise increases the risk of dementia. And while no specific diet is known to reduce dementia risk, research indicates a greater incidence of dementia in people who eat an unhealthy diet compared with those who follow a Mediterranean-style diet rich in produce, whole grains, nuts and seeds.
• Heavy alcohol use. If you drink large amounts of alcohol, you might have a higher risk of dementia. While some studies have shown that moderate amounts of alcohol might have a protective effect, results are inconsistent. The relationship between moderate amounts of alcohol and dementia risk isn't well-understood.
• Cardiovascular risk factors. These include high blood pressure (hypertension), high cholesterol, buildup of fats in your artery walls (atherosclerosis) and obesity.
• Depression. Although not yet well-understood, late-life depression might indicate the development of dementia.
• Diabetes. Having diabetes may increase your risk of dementia, especially if it's poorly controlled.
• Smoking. Smoking might increase your risk of developing dementia and blood vessel (vascular) diseases.
• Sleep apnea. People who snore and have episodes where they frequently stop breathing while asleep may have reversible memory loss.
• Vitamin and nutritional deficiencies. Low levels of vitamin D, vitamin B-6, vitamin B-12 and folate may increase your risk of dementia.

Complications

Dementia can affect many body systems and, therefore, the ability to function. Dementia can lead to:

• Poor nutrition. Many people with dementia eventually reduce or stop eating, affecting their nutrient intake. Ultimately, they may be unable to chew and swallow.
• Pneumonia. Difficulty swallowing increases the risk of choking or aspirating food into the lungs, which can block breathing and cause pneumonia.
• Inability to perform self-care tasks. As dementia progresses, it can interfere with bathing, dressing, brushing hair or teeth, using the toilet independently, and taking medications accurately.
• Personal safety challenges. Some day-to-day situations can present safety issues for people with dementia, including driving, cooking and walking alone.
• Death. Late-stage dementia results in coma and death, often from infection.

Treatment

Most types of dementia can't be cured, but there are ways to manage your symptoms. Medications The following are used to temporarily improve dementia symptoms.

• Cholinesterase inhibitors. These medications — including donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) — work by boosting levels of a chemical messenger involved in memory and judgment.Although primarily used to treat Alzheimer's disease, these medications might also be prescribed for other dementias, including vascular dementia, Parkinson's disease dementia and Lewy body dementia.Side effects can include nausea, vomiting and diarrhea. Other possible side effects include slowed heart rate, fainting and sleep disturbances.
• Memantine. Memantine (Namenda) works by regulating the activity of glutamate, another chemical messenger involved in brain functions, such as learning and memory. In some cases, memantine is prescribed with a cholinesterase inhibitor.A common side effect of memantine is dizziness.
• Other medications. Your doctor might prescribe medications to treat other symptoms or conditions, such as depression, sleep disturbances, hallucinations, parkinsonism or agitation.

Therapies Several dementia symptoms and behavior problems might be treated initially using nondrug approaches, such as:

• Occupational therapy. An occupational therapist can show you how to make your home safer and teach coping behaviors. The purpose is to prevent accidents, such as falls; manage behavior; and prepare you for the dementia progression.
• Modifying the environment. Reducing clutter and noise can make it easier for someone with dementia to focus and function. You might need to hide objects that can threaten safety, such as knives and car keys. Monitoring systems can alert you if the person with dementia wanders.
• Simplifying tasks. Break tasks into easier steps and focus on success, not failure. Structure and routine also help reduce confusion in people with dementia.

 

CEN Alzheimers Disease Overview

Alzheimer's disease is a progressive disorder that causes brain cells to waste away (degenerate) and die. Alzheimer's disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that disrupts a person's ability to function independently. The early signs of the disease may be forgetting recent events or conversations. As the disease progresses, a person with Alzheimer's disease will develop severe memory impairment and lose the ability to carry out everyday tasks. Current Alzheimer's disease medications may temporarily improve symptoms or slow the rate of decline. These treatments can sometimes help people with Alzheimer's disease maximize function and maintain independence for a time. Different programs and services can help support people with Alzheimer's disease and their caregivers. There is no treatment that cures Alzheimer's disease or alters the disease process in the brain. In advanced stages of the disease, complications from severe loss of brain function — such as dehydration, malnutrition or infection — result in death.

Signs and Symptoms

Memory loss is the key symptom of Alzheimer's disease. An early sign of the disease is usually difficulty remembering recent events or conversations. As the disease progresses, memory impairments worsen and other symptoms develop. At first, a person with Alzheimer's disease may be aware of having difficulty with remembering things and organizing thoughts. A family member or friend may be more likely to notice how the symptoms worsen.

Causes

Scientists believe that for most people, Alzheimer's disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time. Less than 1 percent of the time, Alzheimer's is caused by specific genetic changes that virtually guarantee a person will develop the disease. These rare occurrences usually result in disease onset in middle age. The exact causes of Alzheimer's disease aren't fully understood, but at its core are problems with brain proteins that fail to function normally, disrupt the work of brain cells (neurons) and unleash a series of toxic events. Neurons are damaged, lose connections to each other and eventually die. The damage most often starts in the region of the brain that controls memory, but the process begins years before the first symptoms. The loss of neurons spreads in a somewhat predictable pattern to other regions of the brains. By the late stage of the disease, the brain has shrunk significantly.

Risk Factors

• Age
• Family history and genetics
• Down syndrome
• Sex
• Mild cognitive impairment
• Past head trauma
• Poor sleep patterns
• Lifestyle and heart health
• Lifelong learning and social engagement

Complications

Memory and language loss, impaired judgment, and other cognitive changes caused by Alzheimer's can complicate treatment for other health conditions. A person with Alzheimer's disease may not be able to:

• Communicate that he or she is experiencing pain — for example, from a dental problem
• Report symptoms of another illness
• Follow a prescribed treatment plan
• Notice or describe medication side effects

As Alzheimer's disease progresses to its last stages, brain changes begin to affect physical functions, such as swallowing, balance, and bowel and bladder control. These effects can increase vulnerability to additional health problems such as:

• Inhaling food or liquid into the lungs (aspiration)
• Pneumonia and other infections
• Falls
• Fractures
• Bedsores
• Malnutrition or dehydration

Prevention

• Exercise regularly
• Eat a diet of fresh produce, healthy oils and foods low in saturated fat
• Follow treatment guidelines to manage high blood pressure, diabetes and high cholesterol
• If you smoke, ask your doctor for help to quit smoking

Treatment

Current Alzheimer's medications can help for a time with memory symptoms and other cognitive changes. Two types of drugs are currently used to treat cognitive symptoms:

• Cholinesterase inhibitors. These drugs work by boosting levels of cell-to-cell communication by preserving a chemical messenger that is depleted in the brain by Alzheimer's disease. The improvement is modest.Cholinesterase inhibitors may also improve neuropsychiatric symptoms, such as agitation or depression. Commonly prescribed cholinesterase inhibitors include donepezil (Aricept), galantamine (Razadyne) and rivastigmine (Exelon).The main side effects of these drugs include diarrhea, nausea, loss of appetite and sleep disturbances. In people with cardiac conduction disorders, serious side effects may include cardiac arrhythmia.
• Memantine (Namenda). This drug works in another brain cell communication network and slows the progression of symptoms with moderate to severe Alzheimer's disease. It's sometimes used in combination with a cholinesterase inhibitor. Relatively rare side effects include dizziness and confusion.

 

CEN Esophagitis Overview

Esophagitis is inflammation that may damage tissues of the esophagus, the muscular tube that delivers food from your mouth to your stomach. Esophagitis can cause painful, difficult swallowing and chest pain. Causes of esophagitis include stomach acids backing up into the esophagus, infection, oral medications and allergies. Treatment for esophagitis depends on the underlying cause and the severity of tissue damage. If left untreated, esophagitis can damage the lining of the esophagus and interfere with its normal function, which is to move food and liquid from your mouth to your stomach. Esophagitis can also lead to complications such as scarring or narrowing of the esophagus, and difficulty swallowing.

Signs and Symptoms

• Difficult swallowing
• Painful swallowing
• Chest pain, particularly behind the breastbone, that occurs with eating
• Swallowed food becoming stuck in the esophagus (food impaction)
• Heartburn
• Acid regurgitation

Causes

• Reflux esophagitis
• Eosinophilic esophagitis
• Lymphocytic esophagitis
• Drug-induced esophagitis
• Infectious esophagitis

Complications

• Scarring or narrowing (stricture) of the esophagus
• Tearing of the esophagus lining tissue from retching (if food gets stuck) or during endoscopy (due to inflammation)
• Barrett's esophagus, characterized by changes to the cells lining the esophagus, increasing your risk of esophageal cancer

Treatment

Treatments for esophagitis are intended to lessen symptoms, manage complications and treat underlying causes of the disorder. Treatment strategies vary primarily based on the cause of the disorder.  

CEN Gastroenteritis Overview

Viral gastroenteritis is an intestinal infection marked by watery diarrhea, abdominal cramps, nausea or vomiting, and sometimes fever. The most common way to develop viral gastroenteritis — often called stomach flu —is through contact with an infected person or by ingesting contaminated food or water. If you're otherwise healthy, you'll likely recover without complications. But for infants, older adults and people with compromised immune systems, viral gastroenteritis can be deadly. There's no effective treatment for viral gastroenteritis, so prevention is key. In addition to avoiding food and water that may be contaminated, thorough and frequent hand-washings are your best defense.

Signs and Symptoms

• Watery, usually nonbloody diarrhea — bloody diarrhea usually means you have a different, more severe infection
• Abdominal cramps and pain
• Nausea, vomiting or both
• Occasional muscle aches or headache
• Low-grade fever

Causes

You're most likely to contract viral gastroenteritis when you eat or drink contaminated food or water, or if you share utensils, towels or food with someone who's infected. A number of viruses can cause gastroenteritis, including:

• Noroviruses
• Rotavirus

Risk Factors

People who may be more susceptible to gastroenteritis include:

• Young children. Children in child care centers or elementary schools may be especially vulnerable because it takes time for a child's immune system to mature.
• Older adults. Adult immune systems tend to become less efficient later in life. Older adults in nursing homes, in particular, are vulnerable because their immune systems weaken and they live in close contact with others who may pass along germs.
• Schoolchildren, churchgoers or dormitory residents. Anywhere that groups of people come together in close quarters can be an environment for an intestinal infection to get passed.
• Anyone with a weakened immune system. If your resistance to infection is low — for instance, if your immune system is compromised by HIV/AIDS, chemotherapy or another medical condition — you may be especially at risk.

Complications

The main complication of viral gastroenteritis is dehydration — a severe loss of water and essential salts and minerals. If you're healthy and drink enough to replace fluids you lose from vomiting and diarrhea, dehydration shouldn't be a problem. Infants, older adults and people with suppressed immune systems may become severely dehydrated when they lose more fluids than they can replace. Hospitalization might be needed so that lost fluids can be replaced intravenously. Dehydration can be fatal, but rarely.

Treatments

There's often no specific medical treatment for viral gastroenteritis. Antibiotics aren't effective against viruses, and overusing them can contribute to the development of antibiotic-resistant strains of bacteria. Treatment initially consists of self-care measures.  

CEN Peritonitis Overview

Peritonitis is inflammation of the peritoneum — a silk-like membrane that lines your inner abdominal wall and covers the organs within your abdomen — that is usually due to a bacterial or fungal infection. There are two types of peritonitis:

• Spontaneous bacterial peritonitis. Sometimes, peritonitis develops as a complication of liver disease, such as cirrhosis, or of kidney disease.
• Secondary peritonitis. Peritonitis can result from rupture (perforation) in your abdomen, or as a complication of other medical conditions.

Peritonitis requires prompt medical attention to fight the infection and, if necessary, to treat any underlying medical conditions. Peritonitis treatment usually involves antibiotics and, in some cases, surgery. Left untreated, peritonitis can lead to severe, potentially life-threatening infection throughout your body.

Signs and Symptoms

• Abdominal pain or tenderness
• Bloating or a feeling of fullness in your abdomen
• Fever
• Nausea and vomiting
• Loss of appetite
• Diarrhea
• Low urine output
• Thirst
• Inability to pass stool or gas
• Fatigue
• Confusion

Causes

• Medical procedures, such as peritoneal dialysis. Peritoneal dialysis uses tubes (catheters) to remove waste products from your blood when your kidneys can no longer adequately do so. An infection may occur during peritoneal dialysis due to unclean surroundings, poor hygiene or contaminated equipment. Peritonitis may also develop as a complication of gastrointestinal surgery, the use of feeding tubes, or a procedure to withdraw fluid from your abdomen, and rarely as a complication of a colonoscopy or endoscopy.
• A ruptured appendix, stomach ulcer or perforated colon. Any of these conditions can allow bacteria to get into the peritoneum through a hole in your gastrointestinal tract.
• Pancreatitis. Inflammation of your pancreas (pancreatitis) complicated by infection may lead to peritonitis if the bacteria spreads outside the pancreas.
• Diverticulitis. Infection of small, bulging pouches in your digestive tract (diverticulosis) may cause peritonitis if one of the pouches ruptures, spilling intestinal waste into your abdominal cavity.
• Trauma. Injury or trauma may cause peritonitis by allowing bacteria or chemicals from other parts of your body to enter the peritoneum.

Risk Factors

• Peritoneal dialysis. Peritonitis can occur in people undergoing peritoneal dialysis therapy.
• Other medical conditions. The following medical conditions, among others, increase your risk of developing peritonitis: liver cirrhosis, appendicitis, Crohn's disease, stomach ulcers, diverticulitis and pancreatitis.
• History of peritonitis. Once you've had peritonitis, your risk of developing it again may be higher than it is for someone who has never had peritonitis.

Complications

Left untreated, peritonitis can extend beyond your peritoneum, where it may cause:

• An infection throughout your body (sepsis). Sepsis is a rapidly progressing, life-threatening condition that can cause shock, organ failure and death.

Treatments

• Antibiotics. You'll likely be given a course of antibiotic medication to fight the infection and prevent it from spreading. The type and duration of your antibiotic therapy will depend on the severity of your condition and the kind of peritonitis you have. You may be given an antibiotic that treats a wide spectrum of bacteria until doctors have more information about the specific bacteria causing your infection. Then they can more narrowly target your antibiotic.
• Surgery. Surgery is often needed to remove infected tissue, treat the underlying cause of the infection, and prevent the infection from spreading, especially if peritonitis is due to a ruptured appendix, stomach or colon.
• Other treatments. Depending on your signs and symptoms, your treatment while in the hospital will likely include pain medications, fluids given through a tube (intravenous fluids), oxygen and, in some cases, a blood transfusion.

 

CEN Pyelonephritis Overview

Kidney infection (pyelonephritis) is a type of urinary tract infection (UTI) that generally begins in your urethra or bladder and travels to one or both of your kidneys. A kidney infection requires prompt medical attention. If not treated properly, a kidney infection can permanently damage your kidneys or the bacteria can spread to your bloodstream and cause a life-threatening infection. Kidney infection treatment, which usually includes antibiotics, might require hospitalization.

Signs and Symptoms

• Fever
• Chills
• Back, side (flank) or groin pain
• Abdominal pain
• Frequent urination
• Strong, persistent urge to urinate
• Burning sensation or pain when urinating
• Nausea and vomiting
• Pus or blood in your urine (hematuria)
• Urine that smells bad or is cloudy

Causes

Bacteria that enter your urinary tract through the tube that carries urine from your body (urethra) can multiply and travel to your kidneys. This is the most common cause of kidney infections. Bacteria from an infection elsewhere in your body also can spread through your bloodstream to your kidneys. Although it's unusual to develop a kidney infection, it can happen — for instance, if you have an artificial joint or heart valve that becomes infected.

Risk Factors

• Being female. The urethra is shorter in women than it is in men, which makes it easier for bacteria to travel from outside the body to the bladder. The nearness of the urethra to the vagina and anus also creates more opportunities for bacteria to enter the bladder. Once in the bladder, an infection can spread to the kidneys. Pregnant women are at even higher risk of a kidney infection.
• Having a urinary tract blockage. This includes anything that slows the flow of urine or reduces your ability to empty your bladder when urinating — including a kidney stone, something abnormal in your urinary tract's structure or, in men, an enlarged prostate gland.
• Having a weakened immune system. This includes medical conditions that impair your immune system, such as diabetes and HIV. Certain medications, such as drugs taken to prevent rejection of transplanted organs, have a similar effect.
• Having damage to nerves around the bladder. Nerve or spinal cord damage can block the sensations of a bladder infection so that you're unaware when it's advancing to a kidney infection.
• Using a urinary catheter for a time. Urinary catheters are tubes used to drain urine from the bladder. You might have a catheter placed during and after some surgical procedures and diagnostic tests. You might use one continuously if you're confined to a bed.
• Having a condition that causes urine to flow the wrong way. In vesicoureteral reflux, small amounts of urine flow from your bladder back up into your ureters and kidneys. People with this condition are at higher risk of kidney infection during childhood and adulthood.

Treatment

Antibiotics are the first line of treatment for kidney infections. Which drugs you use and for how long depend on your health and the bacteria found in your urine tests. Usually, the signs and symptoms of a kidney infection begin to clear up within a few days of treatment. But you might need to continue antibiotics for a week or longer. Take the entire course of antibiotics recommended by your doctor even after you feel better.