Pancreatitis is an uncommon disease characterized by inflammation of the pancreas.

The pancreas is located deep in the retroperitoneal space of the upper part of the abdomen. It is almost completely covered by the stomach and duodenum. This elongated gland (12–20 cm long in the adult) has a lobe-like structure. Variation in shape and exact body location is common. In most people, the larger part of the gland’s head is located to the right of the spine or directly over the spinal column and extends to the spleen. The gland has both exocrine and endocrine functions. In its exocrine capacity, the acinar cells produce digestive juices, which are secreted into the intestine and are essential in the breakdown and metabolism of proteins, fats, and carbohydrates. In its endocrine function capacity, the pancreas also produces insulin and glucagon, which are secreted into the blood to regulate glucose levels.

Pancreatitis is a disease in which the pancreas becomes inflamed. Pancreatic damage happens when the digestive enzymes are activated before they are released into the small intestine and begin attacking the pancreas.

There are two forms of pancreatitis – Acute and Chronic.

• Acute pancreatitis generally develops suddenly, and it is usually a short-term (a few days to weeks) illness that typically resolves with appropriate medical management. Most people with acute pancreatitis recover completely after getting the right treatment. In severe cases, acute pancreatitis can result in bleeding into the gland, serious tissue damage, infection, and cyst formation. Severe pancreatitis can also harm other vital organs such as the heart, lungs, and kidneys.

• Chronic pancreatitis, which typically develops after multiple episodes of acute pancreatitis, is a long-term condition that can last for months or even several years. Heavy alcohol drinking is another big cause. Damage to the pancreas from heavy alcohol use may not cause symptoms for many years, but then the person may suddenly develop severe pancreatitis symptoms.

Who is at Risk?

People with these conditions or characteristics have a higher risk for pancreatitis:

• Biliary tract disease
• Binge alcohol use and chronic alcoholism
• Recent surgery
• Family history of high triglycerides
• Age (most common ages 35 to 64)
• Smokers
• African Americans are at higher risk than Caucasians and Native Americans.

Causes

There are several possible causes of pancreatitis. The most common are gallstones, which block the duct of the pancreas (for acute pancreatitis), and excessive alcohol consumption (for chronic pancreatitis).

Gallstones – Gallstones are the most common cause of pancreatitis in the United States and other Western countries. Biliary tract disease accounts for 35–50% of all cases. Despite aggressive and intensive early management, the mortality rate is approximately 10%. Although the exact mechanism of pancreatitis due to gallstones is not completely understood, most investigators believe that obstruction of the major papilla by the stone causes reflux of bile into the pancreatic duct. The presence of bile in the pancreatic duct appears to initiate a complex cascade effect that results in  pancreatitis.

Drugs – Drugs are a well-recognized cause of pancreatitis. These drugs may be divided into those that have a definite association, and those with probable association with the development of pancreatitis. These include azathioprine, sulfonamides, corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and antibiotics such as tetracycline.

Pancreas Divisum – The most common congenital anomaly of the pancreas, pancreas divisum, occurs in approximately 10% of the population, and results from incomplete or absent fusion of the dorsal and ventralducts during embryological development. Recent clinical trials have supported the concept that obstruction of the minor papilla may cause acute pancreatitis or chronic pancreatitis in a subgroup of patients with pancreas divisum.

Microlithiasis – Recent studies have shown that a significant number of patients with idiopathic acute pancreatitis will have microlithiasis.

Metabolic Causes – Hyperlipidemia and hypercalcemia may lead to acute pancreatitis. In patients with hyperlipidemia, triglyceride levels are usually greater than 2,000mg/dl. It is believed that lipase present in the pancreatic capillaries metabolizes the levels of triglyceride generating toxic free fatty acids.

Alcohol – Alcohol is the second leading cause of acute pancreatitis in Western countries. In many patients, however, chronic pancreatitis is already established. Alcohol is believed to cause acute pancreatitis by several mechanisms.

Other – There are multiple other causes of pancreatitis that include scorpion stings, poisoning with organophosphorus insecticides, ascaris worms in the pancreatic duct, and trauma

Symptoms

Most people who have acute or chronic pancreatitis experience upper abdominal pain as their primary symptom. Some of those who have chronic pancreatitis may show inflammation on imaging scans, but otherwise may show no symptoms.

Other symptoms of pancreatitis may include:

• Pain that extends from your the side around to the back
• Indigestion
• Nausea or vomiting
• Abdominal tenderness
• Unintentional weight loss
• Bloating with a distended (swollen) stomach
• Hiccups

People who have chronic pancreatitis may also experience steatorrhea, or fatty stools that give off a foul odor. Steatorrhea can be a sign of malabsorption. This means that patients do not get all of the essential nutrients because the pancreas doesn’t secrete enough digestive enzymes to break down your food.

Pain associated with pancreatitis may last from a few minutes to several hours at a time. In severe cases, discomfort from chronic pancreatitis could become constant. The pain is likely to increase after eating or when lying down.

Treatment

Medications – Medical treatment is usually focused on relieving symptoms and preventing further aggravation to the pancreas. Certain complications of either acute pancreatitis or chronic pancreatitis may require surgery or a blood transfusion.

• Drugs – Pancreatitis can cause severe pain. The doctor may prescribe painkillers in order to control that pain. The patient may also receive antibiotics to treat or prevent infection in some cases. The doctor may also prescribe enzyme supplements, such as pancrelipase (Lipram, Pancrease, Viokase), to help the body absorb food. In some cases, doctors may prescribe steroids to treat autoimmune pancreatitis.
• Intravenous (IV) fluids – As the body devotes energy and fluids to repair the pancreas, the patient may become dehydrated. For this reason, the patient is given extra fluids through a vein in the arm during the hospital stay.

Surgery and Other procedures – Different types of surgical procedures may be necessary depending on the cause of the pancreatitis. People who have pancreatic necrosis (tissue death) almost always require surgery to remove damaged and infected tissue. Surgery may also be required to drain an abscess. For chronic pancreatitis with pain that will not respond to treatment, doctors may need to remove a section of the pancreas. If the pancreatitis is a result of gallstones, a procedure called endoscopic retrograde cholangiopancreatography (ERCP) may be necessary. In ERCP, a specialist inserts a tube-like instrument through the mouth and down into the duodenum to access the pancreatic and biliary ducts.

Alternative Treatment

Nutritional Supplements

Grape Seed Extract – Grape seed extract is a very strong anti-inflammatory but it is also one of the most powerful antioxidants on earth and one of the few that will cross the blood-brain barrier. According to research grape seed extract causes cancer cells to die but more importantly grape seed extract helps relieve nausea and pain that are two rotten symptoms of pancreatitis

Curcumin puts out the fire of inflammation and so helps control pain. Curcumin is a powerful pain reliever and one of the best pancreatitis supplements. It fights pancreas inflammation,.  Curcumin is also a very strong antioxidant which seems to inhibit cancer growth by actually causing cancer cells to die.

Vitamin C is another antioxidant, anti-inflammatory and essential nutrient. Vitamin C can do so many things, in combination with grape seed extract and curcumin. Those three pancreatitis supplements in combination are extremely powerful.

Vitamins, Minerals and Antioxidants are important pancreatitis supplements simply because with pancreatitis patients can often suffer from malabsorption which simply means they do not absorb the nutrients from food. Extra vitamins, minerals and antioxidants may be very helpful in providing more energy and all-around better health.

Digestive Enzymes are important pancreatitis supplements simply because the pancreas produces digestive enzymes and the less the pancreas has to work the better. If the pancreas has sustained a large amount of damage it may not produce enough enzymes to digest thefood and of course this makes an enzyme supplement mandatory.

Chromium picolinate mineral helps maintain stable blood sugar levels so the pancreas doesn’t have to work overtime secreting insulin to move sugar out of the blood into cells.

Calcium & Magnesium work hand in hand to promote the health of all glands.

Vitamin B Complex helps relieve stress on the pancreas, and vitamins B-3 and B-5 in particular are important for fat and carbohydrate metabolism.

Dandelion root is an herbal supplement that is commonly used to help treat pancreatitis. Studies suggest that dandelion root helps stimulate and strengthen your pancreas and may improve the function of other organs, too, including the kidneys, spleen and stomach.

Omega 3 fatty acids helps in treating High Triglycerides, inflammation, gallstones. It also reduce the chance of a recurrent episode if you have a history of pancreatitis.

Milk thistle is one of those cholagogue herbs, which have been trusted by herbalists for over thousands of years to treat a damaged, liver, pancreas and stomach. Silymarin, a type of flavonoid has given this herbaceous plant the power to deal with liver damages. Being used as a liver tonic, the extracts of milk thistle help to neutralize all sorts of liver damages, other than protecting the liver as a whole. Other than that, milk thistle is also a source of vitamin E, which helps to treat and regenerate the cells of the liver and pancreas, which get damaged as a result of pancreatitis.

Licorice root has been used as a traditional Chinese herb for treating an array of health disorders, which also includes pancreatitis. Deglycyrrhizinated licorice (DGL) is one of the major bioactive compounds found in licorice, which can be the major reason behind the herb’s effectiveness for treating pancreatitis.

Reference –

http://www.webmd.com/digestive-disorders/digestive-diseases-pancreatitis?page=3

http://www.mayoclinic.org/diseases-conditions/pancreatitis/basics/treatment/con-20028421

http://www.nhs.uk/Conditions/Pancreatitis/Pages/Treatment.aspx

http://www.emedicinehealth.com/pancreatitis/page7_em.htm#medical_treatment_for_pancreatitis

http://www.naturalnews.com/042349_pancreatitis_natural_treatments_digestive_health.html

http://www.medicinenet.com/pancreatitis/page3.htm#what_are_the_signs_and_symptoms_of_pancreatitis

http://www.healthline.com/health/pancreatitis#Types2

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(14)60649-8.pdf

http://www.everydayhealth.com/pancreatitis/treatment/

https://www.pancan.org/section-facing-pancreatic-cancer/learn-about-pan-cancer/treatment/complementary-and-alternative-therapies/

http://pathology.jhu.edu/pancreas/TreatmentNutrition.php?area=tr#cam

http://www.nutraingredients.com/Research/Healthy-oil-components-may-fight-pancreatitis

http://umm.edu/health/medical/altmed/condition/pancreatitis

Mixed connective tissue disease (MCTD) is an autoimmune disease first described in 1972 and is considered an “overlap” of three diseases, systemic lupus erythematosus (lupus), scleroderma and polymyositis. People with MCTD experience symptoms of each of these three diseases.  In many cases, this mixed set of symptoms is eventually dominated by symptoms characteristic of one of the three illnesses, especially scleroderma or lupus.

Mixed connective tissue disease has features of three other connective tissue diseases –

• Systemic lupus erythematosus (SLE) – An inflammatory disease that can affect many different organs. Symptoms include fever, fatigue, joint pains, weakness, and skin rashes on the face, neck, and upper body.
• Scleroderma – Abnormal thickening and hardening of the skin, underlying tissue, and organs
• Polymyositis – Muscle inflammation (swelling)

About 25% of patients with a connective tissue disease (such as dermatomyositis, rheumatoid arthritis, Sjogren’s syndrome, and the three disease listed above), develop another connective tissue disease over the course of several years. This is known as an “overlap syndrome.”

Mixed connective tissue disease occurs most often in women and is usually diagnosed in young adults in their 20s and 30s. Children have also been diagnosed with mixed connective tissue disease.

Mixed connective tissue disease is somewhat of a controversial term among arthritis specialists (rheumatologists). Some question whether mixed connective tissue disease is its own specific disease or whether it’s a precursor to another connective tissue disease.

Causes

The exact underlying cause of mixed connective tissue disease (MCTD) is currently unknown. It is an autoimmune disorder, which means the immune system mistakes normal, healthy cells for those that that body should “fight off.” There are ongoing studies exploring how immune system dysfunction may be involved in the development of this condition.

Risk Factors

Mixed connective tissue disease can occur in people of any age. However, it appears to be most common in women under the age of 30.

Symptoms

In the beginning stages, patients who have MCTD have symptoms similar to those of patients with other connective tissue disorders, including –

• Fatigue
• Muscle pain with no apparent cause
• Joint pain
• Low-grade fever
• Raynaud phenomenon (reduced blood flow to the fingers, toes, ears, and nose). This causes sensitivity, numbness, and loss of color in these areas.

Less common early symptoms may include –

• Severe polymyositis, often in the shoulders and upper arms
• Acute (intense) arthritis
• Aseptic meningitis (inflammation of the brain and spinal cord meninges, not caused by a bacteria or virus)
• Myelitis (inflammation of the spinal cord)
• Gangrene (death and decay) of fingers or toes
• High fever
• Abdominal pain
• Neuropathy (nerve disorders) affecting the trigeminal nerve in the face
• Hearing loss

The “classic” symptoms of MCTD are –

• Raynaud phenomenon
• swollen “sausage-like” fingers, sometimes temporary but at other times progressing into sclerodactyly (thin fingers with hardened skin and limited movement)
• inflamed joints and muscles
• pulmonary hypertension (high blood pressure in the blood vessels of the lungs)

Complications

Mixed connective tissue disease can lead to serious complications, including –

• High blood pressure in the lungs (pulmonary hypertension) – This condition is the main cause of death in people with mixed connective tissue disease.
• Interstitial lung disease – This large group of disorders can cause scarring in the lungs, which affects the ability to breathe.
• Heart disease – Parts of the heart may become enlarged, or inflammation may occur around the heart. Heart disease is the cause of death in about 20 percent of people with mixed connective tissue disease.
• Kidney damage – About one-fourth of people with mixed connective tissue disease develop kidney problems. Sometimes, that damage can lead to kidney failure.
• Digestive tract damage – People may develop abdominal pain and problems with digesting food.
• Anemia – About 75 percent of people with mixed connective tissue disease have iron deficiency anemia.
• Tissue death (necrosis) – People with severe Raynaud’s phenomenon can develop gangrene in the fingers.
• Hearing loss – Often unrecognized, hearing loss may occur in as many as half the people with mixed connective tissue disease.

Treatment

Treatment for MCTD depends on which organs are involved and the severity of the disease. Some people need continuous treatment, while others need it only during periods of heightened disease activity, called flares.

Treatment may include corticosteroids to reduce inflammation and immunosuppressive drugs to suppress the immune system and its attack on healthy tissue. Other medications may be prescribed to treat or reduce the risk of certain complications of the disease.

Treatment considerations include the following –

• Pulmonary hypertension is the most common cause of death in people with MCTD, and must be treated with antihypertensive medications.
• People with a mild form of MCTD may not need treatment, or only low doses of nonsteroidal anti-inflammatory drugs, antimalarials, or low-dose corticosteroids (such as prednisone) to treat inflammation.
• Higher doses of corticosteroids are often used to manage the signs and symptoms of moderate to severe MCTD. If major organs are affected, the patient may have to take immunosuppressants (to suppress the immune system).
• MCTD patients are also at risk of developing heart disease, including an enlarged heart or pericarditis (inflammation around the heart). Patients may need regularly scheduled electrocardiograms to monitor the heart’s condition.

Alternative Treatment

Acupuncture – An acupuncture practitioner inserts tiny needles into the skin at precise points on the body. Studies of acupuncture have found it may help relieve many types of pain. Acupuncture is safe when done by a certified practitioner.

Fish oil supplements – Fish oil supplements have shown some promise in relieving signs and symptoms of other connective tissue diseases, such as lupus and rheumatoid arthritis. Fish oil supplements may help relieve joint pain and stiffness.

Hypnosis – During a hypnotherapy session, a therapist talks in a gentle voice that helps you relax. The therapist helps you reach a state of altered consciousness that lets people focus their mind on their goals or think positively about their challenges. Hypnosis may help relieve pain and stress.

Relaxation techniques – Relaxation techniques may help people take their mind off their signs and symptoms and help people relax. Relaxation techniques include activities such as progressive muscle relaxation and guided imagery. People can learn relaxation techniques from a therapist, or they can do them on their own. Relaxation techniques are generally safe.

Flaxseed – Flaxseed contains a fatty acid called alpha-linolenic acid, which may decrease inflammation in the body. Some studies have found that kidney function may improve in lupus patients who have kidney problems, such as like lupus nephritis.  Abdominal pain and bloating can be side effects of taking flaxseed.

DHEA – DHEA is a steroid molecule manufactured by the cholesterol-pregnenolone pathway, and is an intermediate to androstenediol and androstenedione, which have the potential to become either estrone or testosterone. Supplements containing this hormone have been shown to reduce the dose of steroids needed to stabilize symptoms in some people who have lupus

Herbal Medicine – Feverfew, goldenseal, and pau d’arco are just a few of the helpful herbs one can use, please consult the physician before adding any of these supplements as they may interfere with the other medications or have unwanted effects.

Chiropractic therapy – This therapy relies on the manipulation of the spine to improve the mobility of the joints and reduce pain. Chiropractic therapy practitioners have to go through training and licensing exams, and chiropractic care is often covered by insurance.

Vitamin A – Vitamin A is an antioxidant and is commonly found in whole milk, liver, and some fortified foods. Beta-carotene is a pro-vitamin found in carrots and many colorful vegetables that are then converted to vitamin A in the body.  Vitamin A protects against free radicals (harmful substances in your body) which can damage DNA and lead to cancer and other diseases, and has anti-inflammatory effects.

Vitamin D – People with lupus have shown some benefits from taking Vitamin D supplements   In recent testing, high doses of vitamin D were safe and appeared to temper some of the destructive immune system responses believed to cause lupus. Research is pointing to an immune-regulating role for vitamin D.

Vitamin E – This vitamin supplement comes in several different forms. The alpha-tocopherol type of Vitamin E may help prevent heart disease by slowing the release of inflammatory substances that damage the heart.* Alpha-tocopherol also might be effective for easing lung .inflammation related to allergies. However, because studies were conducted on animals, it’s not yet clear whether the results will translate to humans.

Evening primrose oil – Used to treat inflammation, evening primrose oil is associated with alleviating rheumatoid arthritis.

Reference –

https://www.cedars-sinai.edu/Patients/Health-Conditions/Mixed-Connective-Tissue-Disease.aspx

http://www.cincinnatichildrens.org/health/m/mctd/

https://www.fightlikeagirlclub.com/category/fight-like-a-girl-power-stories/mixed-connective-tissue-disease-stories/

https://www.hss.edu/conditions_undifferentiated-connective-tissue-disease-overview.asp

http://lupusmctd.com/index.php?topic=1088.0;wap2

http://www.arthritisvirginia.com/mixed-connective-tissue-disease.php

http://patient.info/doctor/mixed-connective-tissue-disease

http://www.mayoclinic.org/diseases-conditions/mixed-connective-tissue-disease/basics/causes/con-20026515

http://www.sclero.org/scleroderma/support/stories/english/s/silezia/a-to-z.html

http://www.homeopathicmd.com/2011/04/psychosomatics-and-homeopathy/

Membranous nephropathy is a kidney disorder that leads to changes and inflammation of the structures inside the kidney that help filter wastes and fluids. The inflammation may lead to problems with kidney function. It is also known as Membranous glomerulonephritis.

It occurs when a thin layer in the filtering unit of the kidneys (the glomerulus) becomes inflamed and then appears thickened. This inflammation causes the kidneys to leak protein which can lead to nephritic syndrome which causes the body to retain excess fluid. The fluid appears as swelling which usually starts in the ankles and feet. Membranous nephropathy leads to long term kidney damage.

Causes

About two thirds of membranous nephropathy is what is called ‘idiopathic’. This means that no cause can be identified. However the remaining one third of cases are associated with other conditions, usually diseases which are caused by a disturbance of the immune system. The problem is caused by an autoimmune attack on the cell within the glomerulus that make the glomerular basement membrane, known as podocytes. “Autoimmune” means that the damage is caused by the body’s own immune system.

The thicker glomerular membrane does not work normally. Large amounts of protein are lost in the urine as a result. This condition is one of the most common causes of nephrotic syndrome. It may be a primary kidney disease, or it may be associated with other conditions.

Risk Factors

Factors that can increase your risk of membranous nephropathy include –

• Having a medical condition that can damage the kidneys – Certain diseases and conditions increase the risk of developing membranous nephropathy, such as lupus and other autoimmune diseases.
• Use of certain medications – Examples of medications that can cause membranous nephropathy include nonsteroidal anti-inflammatory drugs and gold salts.
• Exposure to certain infections – Examples of infections that increase the risk of membranous nephropathy include hepatitis B, hepatitis C and syphilis.
• Genetic background – Certain genetic factors make it more likely that people will develop membranous nephropathy.
• Toxins – Exposure to toxins, including gold and mercury

Symptoms

The symptoms of MGN are different for each person. Patients may have no symptoms at all. If symptoms develop, they typically include the following –

• swelling (edema) in the hands, feet, or face
• fatigue
• foamy urine
• excessive need to urinate at night
• weight gain
• poor appetite

MGN causes damage to the kidney, and that results in protein being filtered from the blood and into the urine. Because protein is needed by the body, a lack of protein leads to water retention and swelling. All these symptoms are associated and known as nephrotic syndrome.

Complications

Complications associated with membranous nephropathy include –

• High cholesterol – Levels of cholesterol and triglycerides are often high in people with membranous nephropathy, which greatly increases the risk of heart disease.
• Blood clots – With proteinuria, some may lose proteins that help prevent clotting from the blood into the urine. This makes the person more prone to having blood clots develop in deep veins or blood clots that travel to the lungs.
• High blood pressure – Waste buildup in your blood (uremia) and salt retention can raise blood pressure.
• Infections – Patients are more susceptible to infections when proteinuria causes them to lose immune system proteins (antibodies) that protect people from infection.
• Nephrotic syndrome – High protein levels in the urine, low protein levels in the blood, high blood cholesterol, and swelling (edema) of the eyelids, feet and abdomen can lead to nephrotic syndrome — a cluster of signs and symptoms that affect the kidneys’ filtering ability.
• Acute kidney failure – In cases of severe damage to the kidneys’ filtering units (glomeruli), waste products may build up quickly in the blood. Patient may need emergency dialysis to remove extra fluids and waste from the blood.
• Chronic kidney disease – The kidneys may gradually lose function over time to the point where affected person may need dialysis or a kidney transplant.

Treatment

The goal of treatment is to reduce symptoms and slow the progression of the disease.

Controlling blood pressure is the most important way to delay kidney damage. The goal is to keep blood pressure at or below 130/80 mmHg. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are the medicines most often used to lower blood pressure.

Corticosteroids and other drugs that suppress the immune system may be used.

High blood cholesterol and triglyceride levels should be treated to reduce the risk of atherosclerosis. However, a low-fat, low-cholesterol diet is usually not as helpful for people with membranous nephropathy. Medications to reduce cholesterol and triglyceride levels (most often statins) may be recommended.

A low-salt diet may help with swelling in the hands and legs. Water pills or diuretics may also help with this problem.

Low-protein diets may be helpful. A moderate-protein diet (1 gram of protein per kilogram of body weight per day) may be suggested.

This disease increases the risk for blood clots in the lungs and legs. Patients are occasionally prescribed blood thinners to prevent these complications.

Screening for age-appropriate malignancies is warranted, if not already done.

Alternative Treatment

Zinc – An essential trace element, zinc is a metal that is necessary for human health. Its immune boosting capabilities treat the bacteria that is often associated with membranous glomerulonephritis. In turn, the amount of protein in the body is also reduced.

Magnesium – A key mineral in the human metabolism, magnesium is also an effective treatment option for MGN. Magnesium functions in a number of ways to treat the condition including reducing inflammation, attacking the bacteria in the kidney, balancing immune function and eliminating protein in the kidney.

Vitamin D supplementation may be required for patients with chronic membranous nephritis that is not responsive to treatment. Vitamin D is converted to its active form, 1,25-dihydroxyvitamin D, in the kidney. In chronic kidney disease, the ability of the kidney to synthesize this vitamin is reduced, therefore supplementation is sometimes warranted.

http://emedicine.medscape.com/article/239799-overview

https://clinicaltrials.gov/ct2/show/NCT00050713

http://www.mayoclinic.org/diseases-conditions/membranous-nephropathy/basics/causes/con-20026050

http://www.healthline.com/health/membranous-nephropathy#Symptoms3

http://www.pathologyoutlines.com/topic/kidneymemgn.html

http://www.avicennajmed.com/article.asp?issn=2231-0770;year=2012;volume=2;issue=3;spage=60;epage=64;aulast=Arabi

http://umm.edu/health/medical/ency/articles/membranous-nephropathy

http://cjasn.asnjournals.org/content/3/3/905.full

http://www.uptodate.com/contents/causes-and-diagnosis-of-membranous-nephropathy

Kidney stones (calculi) are hardened mineral deposits that form in the kidney. They originate as microscopic particles or crystals and develop into stones over time. The medical term for this condition is nephrolithiasis, or renal stone disease.

The job of the kidneys is to maintain the body’s balance of water, minerals and salts. Urine is the product of this filtering process. Under certain conditions, substances normally dissolved in urine, such as calcium, oxalate and phosphate, become too concentrated and can separate out as crystals. A kidney stone develops when these crystals attach to one another, accumulating into a small mass, or stone.

Kidney stones vary in size and shape. Stones may be as small as a grain of sand or as large as a pearl. Some stones are even as big as golf balls. Stones may be smooth or jagged and are usually yellow or brown.

Kidney stones come in a variety of mineral types –

• Calcium stones – Most kidney stones are composed of calcium and oxalate. Many people who form calcium containing stones have too much calcium in their urine, a condition known as hypercalciuria There are several reasons why hypercalciuria may occur. Some people absorb too much calcium from their intestines. Others absorb too much calcium from their bones. Still others have kidneys that do not correctly regulate the amount of calcium they release into their urine. There are some people who form calcium oxalate stones as a result of too much oxalate in the urine, a condition known as hypercalciuria In some cases, too much oxalate in the urine is a result of inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, or other times it may be a consequence of prior intestinal surgery. Calcium phosphate stones, another kind of calcium stone, are much less common than calcium oxalate stones. For some people, calcium phosphate stones form as a result of a medical condition known as renal tubular acidosis.
• Struvite stones – Some patients form stones that are composed of a mixture of magnesium, ammonium, phosphate and calcium carbonate, which is known as struvite. These stones form as a result of infection with certain types of bacteria that can produce ammonia. Ammonia acts to raise the pH of urine, which makes it alkaline and promotes the formation of struvite.
• Uric acid stones – Uric acid is produced when the body metabolizes protein. When the pH of urine drops below 5.5, urine becomes saturated with uric acid crystals, a condition known as hypercalciuria. When there is too much uric acid in the urine, stones can form. Uric acid stones are more common in people who consume large amounts of protein, such as that found in red meat or poultry. People with gout can also form uric acid stones.
• Cystine stones – Cystine stones are rare, and they form only in persons with an inherited metabolic disorder that causes high levels of cystine in the urine, a condition known as cystinuria.

Stones may pass out of the kidney, become lodged in the tube that carries urine from the kidney to the bladder (ureter), and cause severe, excrutiating pain that begins in the lower back and radiates to the groin. A lodged stone can block the flow of urine, causing pressure to build in the affected ureter and kidney. Increased pressure results in stretching and spasm, which cause the severe pain.

Kidney stones are one of the most common disorders of the urinary tract. Each year in the United States, people make more than a million visits to health care providers and more than 300,000 people go to emergency rooms for kidney stone problems.

Causes

People develop kidney stones because –

• Their small bowel absorbs too much calcium
• Their diets are too high in calcium or another mineral
• They have intestinal problems
• Urinary tract infections
• They may have inherited a certain disorder that makes their bodies more likely to form kidney stones

Other factors that increase the risk of kidney stones include –

• Not drinking enough fluids (especially in the summer)
• Not exercising enough, or a sedentary lifestyle
• Hypertension, which makes people nearly 3 times more likely to develop kidney stones
• Stress
• Poor dietary habits
• Metabolic syndrome
• Obesity
• Family history of kidney stones
• Continual exposure to high temperatures, which makes people nearly 8 times more likely to form kidney stones
• Other medical conditions, such as gout, chronic diarrhea, certain cancers, and inflammatory bowel disease (IBD)

Kidney Stones in Children – Kidney stones are found in children as young as 5 years. In fact, this problem is so common in children that some hospitals conduct ‘stone’ clinics for pediatric patients. The increase in the United States has been attributed to several factors, mostly related to food choices. The two most important reasons are not drinking enough fluids and eating foods that are high in salt. Kids should eat less salty potato chips and French fries. There are other salty foods: sandwich meats, canned soups, packaged meals, and even some sports drinks. Sodas and other sweetened beverages can also increase the risk of stones if they contain high fructose corn syrup.

Risk Factors

Anyone can have a kidney stone, but it may be more likely if they –

• Are male
• Are Caucasian
• Are very overweight
• Have had kidney infections
• Have a family member with kidney stones
• Have had kidney stones before
• Eat a lot of animal protein (such as meat and eggs)
• Do not drink enough liquids

Other conditions and medicines can also put people at greater risk for kidney stones.

Symptoms

The most common symptoms of kidney stones are blood in the urine or pain. Pain severity and location of pain might vary depending on such factors as stone location and degree of obstruction. Other symptoms include –

• Feeling the need to urinate often
• Inability to urinate (when a stone blocks the urinary tract)
• Nausea
• Vomiting
• Cloudy, foul smelling urine, fever, chills, or weakness might be a sign of a serious infection.

Some kidney stones are called “silent stones” because they do not cause symptoms.

Treatment

Extracorporeal Shock-Wave Lithotripsy – Ultrasound waves are used to break the kidney stone into smaller pieces, which can pass out with the urine. It is used for stones less than two centimetres in size.

Percutaneous Nephrolithotomy – A small incision is made in the back and then a special instrument is used to remove the kidney stone.

Endoscope Removal – An instrument is inserted into the urethra, passed into the bladder, then to where the stone is located. It allows the doctor to remove the stone or break it up so it can pass more easily.

Surgery – This requires an incision in the back to access the kidney and ureter to remove the stone.

Medications – The health care provider may prescribe certain medications to help prevent kidney stones based on the type of stone formed or conditions that make a person more prone to form stones –

• hyperuricosuria—allopurinol (Zyloprim), which decreases uric acid in the blood and urine
• hypercalciuria—diuretics, such as hydrochlorothiazide
• hyperoxaluria—potassium citrate to raise the citrate and pH of urine
• uric acid stones—allopurinol and potassium citrate
• cystine stones—mercaptopropionyl glycine, which decreases cystine in the urine, and potassium citrate
• struvite stones—antibiotics, which are bacteria-fighting medications, when needed to treat infections, or acetohydroxamic acid with long-term antibiotic medications to prevent infection

People with hyperparathyroidism sometimes develop calcium stones.

Self Help –

• Eat antioxidant-rich foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers). Low antioxidant intake is associated with stone formation.
• Eat more high fiber foods, including beans, oats, root vegetables (such as potatoes and yams), and psyllium seed.
• Avoid refined foods, such as white breads, pastas, and sugar.
• Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy is present) or beans for protein. High animal protein intake may cause you to excrete more calcium and uric acid, increasing the risk of stone formation.
• Cut down on oxalate containing foods, such as spinach, rhubarb, beets, nuts, chocolate, coffee, black tea, wheat bran, strawberries, and beans.
• Include foods rich in magnesium and low in calcium, such as barley, bran, corn, rye, oats, soy, brown rice, avocado, banana, and potato.
• Use healthy cooking oils, such as olive oil or coconut oil.
• Reduce or eliminate trans fatty acids, found in such commercially-baked goods as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid coffee and other stimulants, alcohol, and tobacco.
• Drink 6 to 8 glasses of filtered water daily. Some experts recommend doubling previous fluid intake after a stone diagnosis.
• Exercise at least 30 minutes daily, 5 days a week.
• Reduce sodium and sugar intake, both of which are linked to increased risk of stone formation.

Alternative Treatment

Multivitamin – A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins and trace minerals, such as magnesium, zinc, and selenium.

Magnesium citrate used for symptoms of kidney stones. In sensitive people, magnesium can cause loose stools or a drop in blood pressure.

Omega-3 fatty acids, such as fish oil, helps to help reduce inflammation and promote general health. Cold-water fish, such as salmon or halibut, are good sources. Fish oil supplements can increase the effects of certain blood-thinning medications.

Vitamin B6 also commonly referred to as pyridoxine has been found to have exceptional curative success when it comes to curing kidney stones.

IP-6 (Inositol hexophosphonate) taken on an empty stomach, for kidney health.

N-acetyl cysteine, for antioxidant effects.

Probiotic supplement a day, for maintenance of gastrointestinal and immune health. Refrigerate probiotic supplements for best results.

Green tea (Camellia sinensis) standardized extract, for antioxidant and immune effects.

Uva Ursi – On top of enabling to combat infections that are triggered with the onset of kidney stones, Uva Ursi also functions in assisting in pain reduction and cleansing of the urinary tract.

Dandelion Root – The dandelion root has been used for years to treat and manage the symptoms associated with kidney stones. In addition to relieving the pain triggered by kidney stones, organic dandelion root functions in cleansing the urinary tract.

Milk thistle for detoxification support.

Grapefruit seed extract for antibacterial, antifungal, and antiviral activity.

Reference –

http://my.clevelandclinic.org/services/urology-kidney/diseases-conditions/kidney-stones-overview

http://bindingofisaacrebirth.gamepedia.com/Kidney_Stone

http://www.healthcommunities.com/kidney-stones/kidney-stones-overview.shtml

http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/kidney-stones-in-adults/Documents/KidneyStonesAdults_508.pdf

http://patient.info/health/kidney-stones

http://www.nhs.uk/Conditions/Kidney-stones/Pages/Symptoms.aspx

http://www.mayoclinic.org/diseases-conditions/kidney-stones/basics/symptoms/con-20024829

http://www.medicalnewstoday.com/articles/154193.php

http://www.kidney.org.au/your-kidneys/detect/kidney-stones/the-causes-437

http://www.kidneyfund.org/kidney-problems/kidney-stones/symptoms-of-kidney-stones/

http://www.livescience.com/42784-kidney-stones-causes-treatments.html

https://labtestsonline.org/understanding/analytes/kidney-stone-analysis/tab/sample/

http://www.netdoctor.co.uk/conditions/liver-kidney-and-urinary-system/a3026/kidney-stones/

Kidney failure, also known as end-stage kidney disease, occurs when the kidneys are no longer able to adequately remove waste from your blood and control the level of fluid in the body. Kidney failure can happen suddenly or gradually. People with kidney failure need dialysis or a transplant to stay alive.

The kidneys are 2 bean-shaped organs, each about the size of a fist. They are found in the back on either side of the spine. Healthy kidneys clean waste products from the blood by making urine. They also balance the amount of certain elements in the blood (such as sodium, potassium, and calcium), and make hormones that control blood pressure and red blood cells.

If the kidney function fails, the waste products accumulate in the blood and the body. The term for this build-up is azotaemia. Very mild levels of azotaemia may give little or no symptoms, but if the kidney failure continues then symptoms will start to appear. If the kidney (or renal) failure is of sufficient degree to cause symptoms, it is called uraemia.

Causes

Kidney failure can happen rapidly – over days, weeks or months (acute renal failure) or slowly over a period of years (chronic renal failure).

Acute renal failure – This may occur with any serious illness or operation, particularly those complicated by severe infection. Acute kidney injury is common affecting about 20 per cent of those admitted to hospital with acute conditions. If the blood supply to the kidneys is reduced considerably from blood loss, a fall in blood pressure, severe dehydration or lack of salt, then the kidneys may be damaged. If this problem lasts long enough there can be permanent damage to the kidney tissue.

Sudden blockage to the drainage of urine from the kidney can cause damage. A kidney stone is a possible cause of this. Acute kidney damage can occur as a rare side effect of some medications and other rare conditions. Acute kidney damage can occur as a rare side effect of some medications and other rare conditions.

Chronic renal failure – There are many causes of chronic renal failure, including inflammatory conditions affecting the kidney tissue, as a complication of long-standing diabetes mellitus (sugar diabetes), chronic blockage to the drainage of the kidneys and as a result of certain inherited conditions such as polycystic kidney disease.

Often, the cause has occurred many years earlier and cannot be identified. Renal failure can happen rapidly – over days, weeks or months (acute renal failure) or slowly over a period of years (chronic renal failure).

Other conditions that affect the kidneys are –

• Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney’s filtering units. These disorders are the third most common type of kidney disease.
• Inherited diseases, such as polycystic kidney disease, which causes large cysts to form in the kidneys and damage the surrounding tissue.
• Malformations that occur as a baby develops in its mother’s womb. For example, a narrowing may occur that prevents normal outflow of urine and causes urine to flow back up to the kidney. This causes infections and may damage the kidneys.
• Lupus and other diseases that affect the body’s immune system.
• Obstructions caused by problems like kidney stones, tumors or an enlarged prostate gland in men.
• Repeated urinary infections.

Risk Factors

Conditions that can increase your risk of acute kidney failure include –

• Being hospitalized, especially for a serious condition that requires intensive care
• Advanced age
• Blockages in the blood vessels in your arms or legs (peripheral artery disease)
• Diabetes
• High blood pressure
• Heart failure
• Kidney diseases
• Liver diseases

Symptoms

Acute renal failure – Here the symptoms are largely those of the condition causing the acute kidney injury (AKI), such as: –

• blood loss, causing a drop in blood pressure
• vomiting and diarrhoea, causing dehydration
• crush injuries. If large amounts of muscle are damaged there is a release of toxic protein substances that are harmful to the kidneys
• sudden blockage of urine drainage.

Chronic Kidneyfailure – The damage to the kidneys is usually ‘silent’ and not noticed at an early stage. It may be discovered incidentally from blood or urine tests done for other reasons. High blood pressure very commonly occurs with it.

Symptoms are uncommon unless kidney failure is far advanced, when any of the following may be present –

• tiredness
• itching
• loss of appetite
• nausea and vomiting
• breathlessness
• fluid retention, shown as ankle swelling (oedema)

Complications

• Fluid buildup – kidney failure may lead to a buildup of fluid in the lungs, which can cause shortness of breath.
• Chest pain – If the lining that covers the heart (pericardium) becomes inflamed, somemay experience chest pain.
• Muscle weakness – When the body’s fluids and electrolytes — the body’s blood chemistry — are out of balance, muscle weakness can result. Elevated levels of potassium in the blood are particularly dangerous.
• Permanent kidney damage – Occasionally, acute kidney failure causes permanent loss of kidney function, or end-stage renal disease. People with end-stage renal disease require either permanent dialysis — a mechanical filtration process used to remove toxins and wastes from the body — or a kidney transplant to survive.
• Death – Acute kidney failure can lead to loss of kidney function and, ultimately, death. The risk of death is higher in people who had kidney problems before kidney failure.

Treatment

Treatment options vary widely and depend on the cause of kidney failure, but most require a hospital stay. Options are sorted into two groups: treating the cause of renal failure versus replacing the renal function. They include –

• Interventional radiology procedures such as ureteral stenting and nephrostomy: This procedure involves inserting either small stents into the ureter(s) or a tube connected to an external drainage bag. Both options are used to unblock the ureters in order to allow proper urine flow from the kidneys if this has been identified as the cause for the renal failure.
• Surgical treatment such as a urinary stent or kidney stone removal.
• Dialysis, including hemodialysis and peritoneal dialysis: These procedures remove wastes and excess fluid from the blood and therefore replace (some) renal functions. Kidney transplant is the most complete and effective way to replace kidney function but may not be suitable for all patients.

Alternative Treatment

Biodetoxification Prgramme – Safe, intensive treatment for the reduction of the body’s burden of toxic chemicals. Biodetoxification Program utilizes clinical procedures that safely reduce the body’s burden of toxic chemicals, including chemicals stored following occupational, accidental, and/or chronic airborne exposures. Chemicals bind to human tissues on the basis of their lipophilic properties — meaning literally “attracted to fats.”  When our bodies absorb lipophilic toxins, they are deposited in the fat stores and released whenever those fatty tissues are broken down to provide energy. Thus, although a patient may initially be poisoned by an extrinsic (outside) source of toxicants, the patient may continue to be poisoned over a prolonged period of time by our own intrinsic (inside) body stores of those poisons.

Fish Oils – Fish oils affect the progression of CKD. In one meta-analysis some studies indicate a negative effect on the progression of CKD

Vitamin and mineral supplements – Replacement of certain vitamins and minerals that that the patient does not get in the diet or that are lost during dialysis.

Avoiding IV Dye – Avoiding X-ray tests that require IV dye (contrast material), such as an angiogram, an intravenous pyelogram (IVP), and some CT scans. IV dye can cause more kidney damage.

Diet – This may include – Avoid products with added salt, lower potassium foods, limited amount of protein in the diet.

Chinese Herbal Medicine – Acupuncture, Lei Gong Teng, Micro-Chinese Medicine Osmotherapy are the natural alternative treatments for kidney failure which is used externally.

Ayurveda – Gokshura and Mutrakrichantak Churna which contains herbs like Punarnava, Varuna, Shigru, Apamarg etc. maintain effective kidney functioning by promoting proper urination, reducing kidney discomforts and removing stones and helps to reduce accompanying fluid accumulation and kidney tissue inflammation.

Herbal treatment – Cornsilk, dandelion, astragalus, basil etc. helps to cleanse and strengthen the kidney.

Reference –

http://nihseniorhealth.gov/kidneydisease/whatiskidneydisease/01.html

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/kidney-failure

https://www.davita.com/kidney-disease/causes

http://www.webmd.com/a-to-z-guides/understanding-kidney-disease-basic-information

http://lifeoptions.org/kidneyinfo/ckdinfo.php?page=3

http://www.news-medical.net/health/Renal-Failure-Kidney-Failure.aspx

http://www.kidney.ca/kidney-disease

http://www.medicinenet.com/kidney_failure/article.htm

http://www.kidneyfund.org/kidney-disease/kidney-failure/?referrer=https://www.google.co.in/

https://www.nlm.nih.gov/medlineplus/kidneyfailure.html

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia. Iron deficiency anemia occurs when the body does not have enough iron. Iron helps make red blood cells.

Iron is very important in maintaining many body functions, including the production of hemoglobin, the molecule in the blood that carries oxygen. Iron is also necessary to maintain healthy cells, skin, hair, and nails.

Iron from the food that people eat is absorbed into the body by the cells that line the gastrointestinal tract; the body only absorbs a small fraction of the iron the ingest. The iron is then released into the blood stream, where a protein called transferrin attaches to it and delivers the iron to the liver. Iron is stored in the liver as ferritin and released as needed to make new red blood cells in the bone marrow. When red blood cells are no longer able to function (after about 120 days in circulation), they are re-absorbed by the spleen. Iron from these old cells can also be recycled by the body.

Causes

Iron-deficiency anemia may be caused by the following –

• Diets low in iron – Iron is obtained from foods in our diet; however, only 1 mg of iron is absorbed for every 10 to 20 mg of iron ingested. A person unable to have a balanced iron-rich diet may suffer from some degree of iron-deficiency anemia.
• Body changes – An increased iron requirement and increased red blood cell production is required when the body is going through changes, such as growth spurts in children and adolescents, or during pregnancy and lactation.
• Gastrointestinal tract abnormalities – Malabsorption of iron is common after some forms of gastrointestinal surgeries. Most of the iron taken in by foods is absorbed in the upper small intestine. Any abnormalities in the gastrointestinal (GI) tract could alter iron absorption and result in iron-deficiency anemia. Surgery or medications that stop stomach acid production will also decrease iron absorption.
• Blood loss – Loss of blood can cause a decrease of iron and result in iron-deficiency anemia. Sources of blood loss may include GI bleeding, menstrual bleeding, or injury.
• Intravascular hemolysis, a condition in which red blood cells break down in the blood stream, releasing iron that is then lost in the urine. This sometimes occurs in people who engage in vigorous exercise, particularly jogging. This can cause trauma to small blood vessels in the feet, so called “march hematuria.” Intravascular hemolysis can also be seen in other conditions including damaged heart valves or rare disorders such as thrombotic thrombocytopenia purpura (TTP) or diffuse intravascular hemolysis (DIC).

Risk Factors

• Women who menstruate, particularly if menstrual periods are heavy
• Women who are pregnant or breastfeeding or those who have recently given birth
• People who have undergone major surgery or physical trauma
• People with gastrointestinal diseases such as celiac disease (sprue), inflammatory bowel diseases such as ulcerative colitis, or Crohn disease
• People with peptic ulcer disease
• People who have undergone bariatric procedures, especially gastric bypass operations
• Vegetarians, vegans, and other people whose diets do not include iron-rich foods (Iron from vegetables, even those that are iron-rich, is not absorbed as well as iron from meat, poultry, and fish.)
• Children who drink more than 16 to 24 ounces a day of cow’s milk (Cow’s milk not only contains little iron, but it can also decrease absorption of iron and irritate the intestinal lining causing chronic blood loss.)

Symptoms

Most of the time, symptoms are mild at first and develop slowly. Symptoms may include:

• Feeling grumpy
• Feeling weak or tired more often than usual, or with exercise
• Headaches
• Problems concentrating or thinking

As the anemia gets worse, symptoms may include –

• Blue color to the whites of the eyes
• Brittle nails
• Desire to eat ice or other non-food things (pica)
• Feeling lightheaded when you stand up
• Pale skin color
• Shortness of breath
• Sore tongue

Symptoms of the conditions that cause iron deficiency anemia include –

• Dark, tar-colored stools or blood in the stool
• Heavy menstrual bleeding (women)
• Pain in the upper belly (from ulcers)
• Weight loss (in people with cancer)

Complications

• Heart problems – Iron deficiency anemia may lead to a rapid or irregular heartbeat
• Problems during pregnancy – In pregnant women, severe iron deficiency anemia has been linked to premature births and low birth weight babies.
• Growth problems – In infants and children, severe iron deficiency can lead to anemia as well as delayed growth and development.

Treatment

Iron supplements – Iron supplements can be taken over several months to increase iron levels in the blood. Iron supplements can cause irritation of the stomach and discoloration of bowel movements. They should be taken on an empty stomach, or with orange juice, to increase absorption. They are much more effective than dietary interventions alone. In cases of malabsorption or intolerance, IV iron may be needed.

Evaluation for a source of blood loss – This may include upper endoscopy or colonoscopy.

Intravenous Iron – In some cases the doctor may recommend intravenous (IV) iron. IV iron may be necessary to treat iron deficiency in patients who do not absorb iron well in the gastrointestinal tract, patients with severe iron deficiency or chronic blood loss, patients who are receiving supplemental erythropoietin, a hormone that stimulates blood production, or patients who cannot tolerate oral iron. IV iron comes in different preparations:

• Iron dextran
• Iron sucrose
• Ferric gluconate

Blood Transfusions – Red blood cell transfusions may be given to patients with severe iron-deficiency anemia who are actively bleeding or have significant symptoms such as chest pain, shortness of breath, or weakness. Transfusions are given to replace deficient red blood cells and will not completely correct the iron deficiency. Red blood cell transfusions will only provide temporary improvement.

Iron-rich diet – Eating a diet with iron-rich foods can help treat iron-deficiency anemia. Good sources of iron include the following –

• Meats, such as beef, pork, lamb, liver, and other organ meats
• Poultry, such as chicken, duck, turkey, (especially dark meat), liver
• Fish, such as shellfish, including clams, mussels, and oysters, sardines, anchovies
• Leafy greens of the cabbage family, such as broccoli, kale, turnip greens, and collards
• Legumes, such as lima beans and green peas; dry beans and peas, such as pinto beans, black-eyed peas, and canned baked beans
• Yeast-leavened whole-wheat bread and rolls
• Iron-enriched white bread, pasta, rice, and cereals

Digestive Enzymes – Take digestive enzymes. To maximize the benefit of an iron supplement, you may need a digestive enzyme.

Supplements – Folic acid, Vitamin B-12, Extra pantothenic acid (vitamin B-5), Copper, Zinc, Raw spleen glandular, Vitamin A, Natural Beta Carotene and Vitamin E.

Chlorophyll is almost an exact match of the red blood cells or hemoglobin in the human body. With such a unique composition, chlorophyll can serve as a substitute for red blood cells until the body is able to replenish the healthy red blood cell count.

Dong quai – This herb is rich in vitamins and minerals.

Chive – This vegetable is rich in vitamin C and iron – eat fresh chives.

Quinoa – This is a grain rich in all eight essential amino acids that form a complete protein.

Gentian – The bitter herb gentian is popular in England for the treatment of anemia. Gentian can be brewed into a tea or you can take a commercially available extract.

Dandelion is also believed to help people with anemia. It is very rich in vitamins and minerals.

Other herbs that are of interest to those suffering from anemia include alfalfa, bilberry, burdock root, cherry, goldenseal, grape skins, hawthorn berry, horsetail, mullein, parsley, nettle, Oregon grape root, pau d’arco, red raspberry, shepherd’s purse, watercress, and yellow dock root.

Reference –

http://www.irondisorders.org/iron-deficiency-anemia

https://www.merckmanuals.com/professional/hematology-and-oncology/anemias-caused-by-deficient-erythropoiesis/iron-deficiency-anemia

http://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf

http://www.health.com/health/gallery/0,,20798655,00.html

http://www.hematology.org/Patients/Anemia/Iron-Deficiency.aspx

http://patient.info/health/iron-deficiency-anaemia-leaflet

https://umm.edu/health/medical/ency/articles/iron-deficiency-anemia

http://www.bsg.org.uk/clinical-guidelines/small-bowel-nutrition/guidelines-for-the-management-of-iron-deficiency-anaemia.html

Intestinal ischemia also called visceral or mesenteric ischemic syndrome, is the term used to describe the result of a variety of disorders that cause insufficient blood flow to the gastrointestinal tract. Such ischemic injuries can manifest with symptoms ranging from a mild bout of short-lived abdominal pain, to bloody diarrhea or a more serious situation that may require surgery and even end in death.

The three major abdominal blood vessels that may become blocked include the celiac artery, superior mesenteric artery or inferior mesenteric artery. Usually two or three of these arteries must be narrowed or blocked to cause intestinal ischemic syndromes.

In general terms, ischemia either can be localized to a relatively small part of the small intestine or colon, or it may be more widespread and involve significant portions of both.

The time course of the ischemic event also may vary and be acute (new), chronic (long-standing), or recurrent.

An ischemic problem may be caused by an interruption in blood passage through an artery (a blood vessel that brings blood to the intestines) or vein (a blood vessel that returns blood from the intestines to the heart). There are several ways in which arterial blood supply to the intestines can be restricted: an embolus (a migrating blood clot that can form a blockage), a thrombus (a stationary clot attached to the wall of a blood vessel that can prohibit blood passage), or a so-called non-occlusive state (spasm of a blood vessel, but without permanent obstruction, that restricts blood flow through an artery).

Venous problems also may result in intestinal ischemia, although less commonly than arterial causes. The most common cause of ischemia from venous obstruction is a thrombus which interferes with the return of blood flow from the intestines, produces intestinal congestion, and results in intestinal swelling, and occasionally bleeding.

Causes

Acute Intestinal Ischemia: The arteries supplying oxygen-rich blood and nutrients to your intestines can become narrowed from atherosclerosis in the same way that coronary (heart) arteries become narrowed in heart disease. Mesenteric ischemia can develop if the narrowing or blockage become severe.

Another cause of acute ischemia is a blood clot. If a blood clot forms or travels to the narrowed artery, the blood supply to the intestine is suddenly interrupted. The tissues below the blocked vessel will be starved for oxygen-rich blood and die. This event is a life-threatening condition.

Chronic Intestinal ischemia is characterized by narrowing of the blood vessels that supply the intestines with nutrients and oxygen-rich blood. This narrowing also is caused by atherosclerosis (buildup of fatty matter and plaque on the blood vessel walls). Chronic mesenteric ischemia is more common in women than men, and occurs after age 60.

A potentially dangerous complication of chronic mesenteric ischemia is the development of a blood clot within a diseased artery, causing blood flow to be suddenly blocked (acute mesenteric ischemia).

Risk Factors

• Smoking
• Diabetes
• Hypertension (high blood pressure)
• High lipid values (cholesterol, LDL, triglycerides)

Symptoms

Early signs and symptoms of acute intestinal ischemia include –

• Severe abdominal pain, concentrated in one area of the abdomen
• Nausea and/or vomiting
• Bloody stools
• History of chronic atrial fibrillation or cardiovascular disease

Chronic –

The organs of the gastrointestinal system are responsible for the digestion of food. Therefore, decreased blood supply to these organs cause symptoms related to eating or after-meal digestion, including –

• Abdominal pain after meals
• Weight loss
• Fear of eating or change in eating habits due to post-meal pain
• Nausea and/or vomiting
• Constipation or diarrhea
• History of cardiovascular disease (such as peripheral arterial disease, stroke, coronary artery disease or heart attack)

Complications

• Death of intestinal tissue – If blood flow to the intestine is completely and suddenly blocked, intestinal tissue can die (gangrene).
• Perforation – A hole through the wall of the intestines can develop. This results in the contents of the intestine leaking into the abdominal cavity, causing a serious infection (peritonitis).
• Scarring or narrowing of the colon – Sometimes the intestines can recover from ischemia, but as part of the healing process the body forms scar tissue that narrows or blocks the intestines.
• Death

Treatment

Surgery – Emergency surgery may be performed to remove the blood clot (embolectomy) or bypass the blocked vessel and restore blood flow to the intestines. The surgeon may use autologous bypass grafts (patient’s own blood vessels) or artificial grafts. In some cases, the surgeon may need to remove a portion of the intestine if tissue death has occurred.

In Chronic situation surgery may be performed to remove plaque (endarterectomy), bypass the blocked vessel to restore blood flow to the intestines, or remove or repair an aneurysm. The surgeon may use autologous bypass grafts (patient’s own blood vessels) or artificial grafts during the bypass procedure.

Medication – Anticoagulant medications, such as Coumadin (warfarin – a blood-thinner), to reduce the risk of blood clots.

Angioplasty and stenting – A balloon catheter is used to attempt to open the artery and a small stent is placed inside the artery to keep it open.

Alternative Treatment

Quercetin is a naturally occurring flavonoid with antioxidant, anti-inflammatory, and anticancer properties. Quercetin has been shown to enhance intestinal barrier functions in human intestinal cells.88 Mast cells play an important role in the pathogenesis of intestinal mucosal inflammation and increased IP. Quercetin helps to control intestinal inflammation by inhibiting histamine release from human intestinal mast cells.

Ginkgo biloba extract (GBE) has antioxidant and free radical–scavenging properties with cytoprotective effects on cells of the gastrointestinal mucosa. Oral supplementation with GBE has been shown to reduce macroscopic and histological damage to the colonic mucosa in vivo and to significantly decrease pro-inflammatory cytokines in experimentally induced ulcerative colitis.

Vitamins C and E plays an essential roles in protecting intestinal mucosal cells from oxidative damage and free-radical pathology.

N-acetyl-L-cysteine (NAC) is an antioxidant, detoxifier, and precursor for glutathione synthesis on oral administration in humans. NAC and glutathione quench free radicals that can contribute to oxidative damage of the intestinal mucosa.

L-glutamine is an important energy source for cells of the intestinal mucosa and has been shown to be conditionally essential for normal mucosal structure and function. Glutamine appears to be required for normal production of secretory immunoglobulin A (IgA) in the intestines.

N-acetyl-D-glucosamine (NAG) is a naturally occurring aminoglycan found in large concentrations in intestinal mucus, secretory IgA, and other immunoglobulins. Intestinal mucus plays a critical role in protecting the host by providing a mechanical and immunological barrier against toxins, antigens, and bacteria in the gut lumen.

Pancreatic enzymes have optimal activity in the neutral to alkaline pH range and are unstable in acidic conditions.

Probiotics Intestinal microflora have been described as a postnatally acquired organ comprised of a large diversity of bacteria that perform a range of important functions for the host. Probiotics are orally administered microorganisms that help to maintain or restore beneficial intestinal microflora and prevent or treat gastrointestinal disorders and related systemic conditions.

Psyllium seed and flaxseed fiber each demonstrate benefits of both soluble and insoluble dietary fiber in humans. It helps in intestinal health.

Boswellia is an excellent herb helping to reduce immune cells that promote inflammation while increasing the number of immune cells that inhibit inflammation.

Chamomile is a popular herb best known for it’s calming properties. It helps to calm muscle spasm in stomach and has anti-inflammatory properties helping to reduce symptoms of ischemia.

Reference –

http://www.drugs.com/mcd/intestinal-ischemia

http://radiopaedia.org/articles/intestinal-ischaemia

http://www.webmd.com/digestive-disorders/intestinal_ischemia_infarction

https://www.nlm.nih.gov/medlineplus/ency/article/001151.htm

http://emedicine.medscape.com/article/189146-overview

http://avsurgery.com/mesenteric-ischemia-intestinal-angina/

Interstitial cystitis (IC), is a chronic pain condition that affects the bladder. Many experts now call it bladder pain syndrome (BPS). It is a feeling of pain and pressure in the bladder area. Along with this pain are lower urinary tract symptoms which have lasted for more than 6 weeks, without having an infection or other clear causes.

A normal urinary bladder should not cause pain. Pain, irritation or hypersensitivity in and around the bladder, with a frequent and often urgent need to urinate – whether sudden and acute or gradually developing and chronic – can have many different causes. It may be related to the urinary tract, the genital tract, the bowel, nervous system or muscular system. It may be due, for example, to bacterial, viral or fungal infections, infestations, stones, benign or malignant tumours, endometriosis, systemic autoimmune disease, drugs or chemicals, and including more recently ketamine abuse.

However, if a thorough investigation has revealed none of these disorders, there is another possibility, IC may be the cause. Interstitial cystitis/bladder pain syndrome, is a distressing, chronic bladder disorder of unknown cause, with persistent or recurrent symptoms of pain, irritation, pressure or discomfort related to the bladder and usually accompanied by a frequent and urgent need to urinate day and night. While the symptoms may resemble a urinary tract infection (cystitis), there is no infection to be seen in the urine and tests reveal no identifiable disorder that could account for the symptoms.

How the Urinary System Works ?

The bladder is relaxed, when it is not full of urine.  When nerve signals in the brain let the bodies know that the bladder is getting full, the person feels the need to pass urine.  If the bladder is working normally, the body can put off urination for some time. Once the body is ready to pass urine, the brain sends a signal to the bladder.  Then the bladder muscles squeeze (or “contract”).  This forces the urine out through the urethra, the tube that carries urine from the body.  The urethra has muscles called sphincters.  They help keep the urethra closed so urine doesn’t leak before the body is ready to go to the bathroom.  These sphincters relax when the bladder contracts. IC/PBS is caused when this normal process is affected.

Who is at risk?

More than 1.3 million Americans have IC/BPS, but studies suggest that, millions more may have symptoms of IC/BPS. An estimated 3.3 million U.S. women, or 2.7 percent, who are 18 years of age or older have pelvic pain and other symptoms, such as urinary urgency or frequency, that are associated with IC/PBS.1 An estimated 1.6 million U.S. men, or 1.3 percent, who are 30 to 79 years old have persistent symptoms, such as pain with bladder filling or pain relieved by bladder emptying, that are associated with PBS. Most people with IC/BPS are diagnosed in middle age, but it may be diagnosed in teenagers and senior citizens as well.

Causes

Causes may include –

• A defect in the bladder wall that allows substances in the urine to irritate the bladder.
• A specific type of cell that releases histamine (chemical released during an allergic reaction) and other chemicals, which lead to symptoms of IC/BPS.
• Something in the urine that damages the bladder.
• Changes in the nerves that carry bladder sensations, making normal events, such as bladder filling, painful.
• The body’s immune system attacks the bladder.

The causes of IC/BPS in some people may be different than the causes in other people with IC/BPS. Studies of people who have IC/BPS suggest that it sometimes develops after an injury to the bladder, such as an infection. Genes also may play a role in some forms of IC/BPS. In some cases, IC/BPS affects both a mother and daughter or sisters. Still, IC/BPS does not commonly run in families.

Many women with IC/PBS have other conditions such as irritable bowel syndrome and fibromyalgia. Scientists believe IC/PBS may be a bladder manifestation of a more general condition that causes inflammation in various organs and parts of the body.

Symptoms

IC/BPS can get in the way of the affected person’s social life, exercise and sleep, and can cause a great deal of distress. Without treatment, IC/BPS symptoms make it hard to get through the day or even be able to work. IC/BPS may affect the relationship with his/her spouse and family. It can also rob a person of a good night’s sleep. Too little sleep will leave the patient tired and unhappy.

• Pain –
  • Pain, irritation, pressure, discomfort or other unpleasant sensation that may worsen as the bladder fills;
  • Urinating often alleviates the pain and may give a temporary sense of relief;
  • Suprapubic pain or discomfort, pelvic pain (lower abdominal pain), sometimes extending to the lower
  • Part of the back, the groin and thighs;
  • In women there may be pain in the vagina and vulva;
  • In men, pain in the penis, testicles, scrotum and perineum;
  • Both men and women may have pain in the urethra and rectum;
  • Pain with sexual intercourse in both men and women (dyspareunia); pain on ejaculation in men;
  • Pain may worsen or be triggered by specific foods or drinks or even medication;
  • A frequent need to urinate (frequency), including at night (night-time frequency or nocturia); an often urgent or overwhelming need to urinate (urgency).

• Urinary Frequency – Means that a person needs to urinate more frequently than normal during the daytime and at night. People with severe interstitial cystitis may urinate as often as 60 times a day. Frequency is by no means always related to bladder size. While some patients have a type of IC with a shrunken bladder with a scarred, stiff wall (fibrosis) and a small capacity under anaesthesia, other IC/BPS patients with a normal-sized bladder may nevertheless have severe frequency due to hypersensitivity on filling. A typical feature of IC/BPS is the need to empty the bladder several or multiple times during the night. The amount of urine passed may be small, even just a few drops.
• Urinary urgency – In IC/BPS is an urgent or overwhelming need to empty the bladder due to increasing pain or discomfort or other unpleasant sensation that becomes impossible to tolerate any longer, and may in some patients be accompanied by a feeling of malaise and/or nausea. Some patients find that having to postpone urination leads to retention or difficulty in getting the flow started. The nature and cause(s) of this urgency sensation in IC/BPS patients are still not fully understood.

IC/PBS & Pregnancy – IC/BPS is not thought to affect fertility or the health of the unborn baby. Some women find that their IC/BPS symptoms get better during pregnancy. Others find their symptoms get worse. If you are thinking about becoming pregnant, talk to your doctor about your IC/BPS and any medicines you might be using to treat IC/BPS or other conditions. Some medicines and treatments are not safe to use during pregnancy.

Treatment

Conventional Treatment

Most conventional treatments are aimed at symptom control.  IC/BPS treatment is often done in phases with constant monitoring of your pain and quality of life.  It is important to talk to your health care provider about how your treatments are working so that together you can find the best treatment option for you.

The following are the different phases of IC/BPS treatment:

• Lifestyle changes – Lifestyle changes, known as “behavioral therapy,” are often the first treatments used to manage IC/BPS. This includes – Manipulative Physical therapy, Limiting Stress, Limiting certain Foods & Drinks. There is evidence that physical therapy exercises to strengthen the pelvic floor muscles do not improve symptoms, and often make them worse, so activities such as Kegel exercises are not recommended for patients with IC/BPS.
• Prescription Drugs – There are many types of oral drugs, and the side effects range from drowsiness to upset stomach. Intravesical prescription drugs are placed directly into the bladder with a catheter. This includes –
  • Oral Pentosan Polysulphate – It builds and restores the protective coating of the bladder tissue. It may also help by decreasing swelling or by other actions. Possible side effects are not common, but may include nausea, diarrhea and gastric distress.
  • DimethylSulfoxide (DMSo) – This blocks swelling, decrease pain sensation and remove a type of toxin called “free radicals” that can damage tissue.
  • Hydroxyzine – Hydroxyzine is an antihistamine. It is thought that some patients with IC/BPS have too much histamine in the bladder that leads to pain and other symptoms. An antihistamine may be helpful in treating IC/BPS. The main side effect is drowsiness.
  • Amitriptyline – This is described as an antidepressant, but it actually has many effects that may improve IC/BPS. It has antihistamine effects, decreases bladder spasms, and slows the nerves that carry pain messages.  Amitriptyline is widely used for other types of chronic pain such as cancer and nerve damage.  The most common side effects are drowsiness, constipation and increased appetite.
  • Heparin – Heparin is similar to pentosan polysulfate and probably helps the bladder by similar mechanisms. Heparin must be placed into the bladder with a catheter. Complications are rare because the heparin stays in the bladder only and does not usually affect the rest of the body.
• Nerve Stimulation – This includes
  • Transcutaneous electrical nerve stimulation (TENS)
  • Sacral nerve stimulation
• Sacral nerve stimulation – Bladder distention is the stretching of the bladder with water or gas. The procedure may be repeated as a treatment if the response is long lasting.

Alternative Treatment

Nutritional Supplement

• Quercetin – It is a bioflavonoid that may have anti-inflammatory properties. A small double-blind placebo-controlled trial found that a supplement containing quercetin reduced symptoms of interstitial cystitis.
• Arginine – The amino acid arginine helps the body make nitric oxide, a substance that relaxes smooth muscles like those found in the bladder. Based on this mechanism, arginine has been proposed as a treatment for IC.
• Glycosaminoglycans – There is some evidence that in interstitial cystitis the surface layer of the bladder is deficient in protective natural substances called glycosaminoglycans. This in turn might allow the bladder to become inflamed; it might also initiate autoimmune reactions.
• Calcium citrate alkalinizes the urine, which decreases irritation to the bladder.
• Bromelain provides anti-inflammatory action.
• Omega-3 Fatty Acids – This is known for its ability to decrease systemic inflammation in the tissue and membranes.
• Probiotics also help restore normal flora and lessen inflammation, plus help to combat systemic yeast triggers.
• Estrogen plays a significant role in inflammation, and during times of great hormonal imbalances your body could be more susceptible to inflammation that can lead to interstitial cystitis.
• Calcium-Magnesium with Vitamin D

Herbs

• Gotu kola – It enhances the integrity of connective tissue by stimulating production of glycosaminoglycans, which are an integral component of the protective mucous layer in the bladder.
• Buchu (Barosma betulina)—A soothing diuretic and antiseptic for the urinary system.
• Cleavers (Galium aparine)—Traditionally used as a urinary tract tonic.
• Corn silk (Zea mays)—Has soothing and diuretic properties.
• Horsetail (Equisetum arvense)—An astringent and mild diuretic with tissue-healing properties.
• Marshmallow root (Althea officinalis)—Has soothing demulcent properties. It is best taken as a cold infusion; soak the herb in cold water for several hours, strain, and drink.
• Usnea (Usnea barbata)—Has soothing and antiseptic properties.
• Supplemental greens – alfalfa, green barley, spirulina, kelp, chlorella, wheat grass, chlorophyll and blue-green algae. These nutrient packed greens are an excellent way to supplement a diet low in fresh greens.

Reference

http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/interstitial-cystitis-painful-bladder-syndrome/Pages/facts.aspx#cause

http://www.urologyhealth.org/urologic-conditions/interstitial-cystitis/symptoms

http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/interstitial-cystitis-painful-bladder-syndrome/Pages/facts.aspx#cause

http://www.urologyhealth.org/urologic-conditions/interstitial-cystitis/treatment

http://www.interstitial-cystitis-alternatives.org/

http://www.itmonline.org/arts/cystitis.htm

http://www.healthcommunities.com/interstitial-cystitis/alternativetreatment.shtml

http://www.healthcommunities.com/interstitial-cystitis/alternativetreatment.shtml

Kidney stones are on the rise. One cause is a condition called hyperoxaluria — when a person has too much oxalate in his or her urine. Oxalate is a natural chemical in the body, and it’s also found in certain types of food. There is no known need for oxalate by the human body, it is normally eliminated as waste through the kidneys. But too much oxalate in the urine can cause serious problems when the excess oxalate binds with calcium in the urine to form kidney stones.

The primary hyperoxalurias are autosomal recessive disorders of which three have been described at the molecular level.

• Primary hyperoxaluriatype 1 (PH1) is caused by mutations in AGXT which result in dysfunction of the vitamin B6 (pyridoxine) dependent liver specific peroxisomal enzyme alanine: glyoxylate aminotransferase (AGT)
• Primary hyperoxaluriatype 2 (PH2) arises from mutations in GRHPR with subsequent dysfunction of the enzyme glyoxylate/hydroxypyruvate reductase (GRHPR).
• Primary hyperoxaluriatype 3 (PH3) arises from mutations in HOGA1 which is encodes the mitochondrial enzyme 4-hydroxy-2-oxoglutarate aldolase.

Hyperoxaluria can be caused by eating too many oxalate-rich foods, an intestinal disease or an inherited (genetic) disorder. In some persons the cause of the disease is not known, but may result from changes in the way kidneys handle normal amounts of body oxalate. Hyperoxaluria is uncommon, though can be found in about 20 percent of individuals with kidney stones. Quick diagnosis and treatment of hyperoxaluria is important to the long-term health of the kidneys.

Causes

Dietary hyperoxaluria – Eating a diet of high oxalate content foods can cause high levels of oxalate in the urine and can increase your risk of hyperoxaluria or kidney stones. Generally, if diet changes are made the urine oxalate will then decrease.

Enteric hyperoxaluria – Several intestinal diseases, including Crohn’s disease and short bowel syndrome as a result of surgical procedures like Bariatric surgery may increase the absorption of oxalate from foods, which can then increase the amount of oxalate excreted in the urine. Avoiding, foods high in oxalate in particularly important.

Primary hyperoxaluria (PH) – Is a rare, inherited (genetic) disorder of liver metabolism that often results in life-threatening damage to the kidneys. In this type, the liver doesn’t create enough of a certain protein (enzyme) that prevents overproduction of oxalate, or the enzyme doesn’t work properly. Unlike dietary or enteric hyperoxaluria, the amount of oxalate in the urine is not greatly affected by changes in dietary oxalate.

Symptoms

Commonly, kidney stones are the first sign of hyperoxaluria. Kidney stones are uncommon in childhood. Kidney stones that form in children and teenagers are likely to be caused by an underlying condition, such as hyperoxaluria. For this reason, all young people with kidney stones should have a thorough evaluation, including measurement of oxalate in the urine. Adults with recurrent kidney stones also should be evaluated for oxalate in the urine.

Symptoms of a kidney stone can include the following –

• Severe or sudden abdominal or flank pain
• Blood in the urine
• Frequent urge to urinate
• Pain when urinating
• Fever and chills
• Primary hyperoxaluria (PH) that goes untreated can eventually damage your kidneys. Over time your kidneys may stop working. For some people, this is the first sign of the disease.

Symptoms of kidney failure can include the following –

• Decrease in urine output or no urine output at all
• Feeling generally ill, tired or heavy fatigue
• Loss of appetite, nausea and vomiting
• Pale skin color related to anemia

Oxalosis in its late stages can cause a variety of complications outside the kidney, including bone disease, anemia, skin ulcers, heart and eye problems, and in children, a failure to develop and grow normally.

Treatment

Medications – Prescription doses of vitamin B-6 can be effective in reducing oxalate in some people with hyperoxaluria. Oral preparation of neutral phosphates and citrate also can be effective to help prevent the formation of calcium oxalate crystals. Other medications like thiazide diuretics may also be considered, depending on the abnormalities present in the urine.

High fluid intake – If people have normal kidney function the doctor will likely tell them to drink more water or other fluids. The extra fluid flushes the kidneys, prevents oxalate crystal buildup and helps prevent kidney stones from forming. Most important — drinking enough fluid will help reduce the chances of a kidney stone.

Dietary modifications – For patients with enteric or dietary hyperoxaluriaz changes in diet may include restricting foods high in oxalate, limiting salt, decreasing sugar and reducing animal protein such as meat, eggs and fish. Also, it is important to ensure that people are getting enough calcium from food. Dietary restrictions may not be as important for people with primary hyperoxaluria. Follow the advice of the doctor or registered dietician.

Kidney stone management – Kidney stones are common in people with hyperoxaluria, but they don’t always need to be treated. If large kidney stones are causing pain or blocking urine flow, people may need to have them removed or broken up so they can pass in the urine.

Dialysis and transplant – Depending on the severity of the hyperoxaluria, people may eventually lose kidney function. Kidney dialysis may help temporarily, but it doesn’t keep up with the amount of oxalate produced.

Alternative Treatment

Magnesium intake may decrease the risk for kidney stones.

Reference –

http://www.medicinenet.com/script/main/art.asp?articlekey=10792

https://www.counsyl.com/services/family-prep-screen/diseases/primary-hyperoxaluria-type-2/

http://emedicine.medscape.com/article/444683-overview#a5

http://www.hopkinsmedicine.org/dnadiagnostic/tests/tests/primary-hyperoxaluria-type-1-test

http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Expert=93598

http://www.rarekidneystones.org/hyperoxaluria/

https://www.auanet.org/university/live-course-handout.cfm?id=1083&video=1458&agenda=6888

https://www.researchgate.net/publication/17687757_Treatment_of_Primary_Hyperoxaluria

http://www.raysahelian.com/kidneystones.html

Hypercalcemia is an elevated calcium level in the blood. Hypercalcemia can be asymptomatic in laboratory results, but high calcium levels are often an indicator of multiple myeloma. Hypercalcemia related to multiple myeloma is caused by the breakdown of bone which leads to the release of calcium into the blood. This can be a serious problem if appropriate treatment is not given immediately. Severe hypercalcemia can result in coma or cardiac arrest.

Hypercalcemia develops in 10%–20% of adults with cancer, but it rarely develops in children. When it develops in people with cancer, it may be called hypercalcemia of malignancy (HCM)

Calcium enters the blood in different ways. The level of calcium in the blood is controlled by hormones and the kidneys.

Calcitriol is a hormone form of vitamin D. It helps the intestines take up calcium from foods and drinks. The intestines then release calcium into the blood. Parathyroid hormone (PTH) helps control the level of calcium in the blood. When blood calcium levels are low, the parathyroid gland releases PTH. PTH stimulates cells in the bones to break bone down and release calcium into the blood. It also tells the kidneys and intestines to absorb more calcium. The kidneys help control the amount of calcium in the body. They can remove large amounts of calcium from the blood and pass it into the urine.

Severe hypercalcemia can have serious consequences, including kidney damage, dementia, and coma. Treating the underlying disorder is often sufficient to restore blood levels of calcium to normal. However, some of the problems associated with severe hypercalcemia are irreversible.

Causes

Calcium is important to many body functions, including –

• Bone formation
• Hormone release
• Muscle contraction
• Nerve and brain function

Parathyroid hormone (PTH) and Vitamin D help manage calcium balance in the body. PTH is made by the parathyroid glands, which are four small glands located in the neck behind the thyroid gland. Vitamin D is obtained when the skin is exposed to sunlight, and from dietary sources such as –

• Egg yolks
• Fish
• Fortified cereals
• Fortified dairy products

Primary hyperparathyroidism is the most common cause of hypercalcemia. It is due to excess PTH release by the parathyroid glands. This excess occurs due to an enlargement of one or more of the parathyroid glands, or a growth on one of the glands. (Most of the time, these growths are not cancerous).

Other conditions can also cause hypercalcemia –

• An inherited condition that affects the body’s ability to regulate calcium (familial hypocalciuric hypercalcemia)
• Being bed-bound (or not being able to move) for a long period of time (this occurs most often in young people)
• Calcium excess in the diet. This is called milk-alkali syndrome. It is most often due to at least 2,000 milligrams of calcium per day. Taking too much vitamin D may add to the problem.
• Hyperthyroidism
• Kidney failure
• Medications such as lithium and thiazide diuretics (water pills)
• Some cancerous tumors (for example, lung cancers, breast cancer)
• Some infectious and inflammatory diseases such as tuberculosis, Paget’s disease and sarcoidosis

Women in their 50s are the population at highest risk of overactive parathyroid glands.

Symptoms

The symptoms of hypercalcemia often develop slowly and may be similar to the symptoms of cancer or cancer treatment. How serious a person’s symptoms are is not related to the calcium level in the blood. Many patients have no symptoms. And, older patients usually experience more symptoms than younger patients.

People with hypercalcemia may experience the following symptoms –

• Loss of appetite
• Nausea and vomiting
• Constipation and abdominal pain
• Increased thirst and frequent urination
• Fatigue, weakness, and muscle pain
• Confusion, disorientation, and difficulty thinking
• Headaches
• Depression

Symptoms of severe hypercalcemia may include –

• Kidney stones, a painful condition in which salt and minerals form solid masses called stones in the kidneys or urinary tract
• Irregular heartbeat
• Heart attack
• Loss of consciousness
• Coma

Patients and their families should be familiar with the symptoms on this list. Relieving side effects is an important part of cancer care and treatment. This is called palliative care. Talk with your health care team about any symptoms or side effects you may experience. This includes any new symptoms or a change in symptoms.

Complications

• Pancreatitis
• Peptic ulcer disease
• Calcium deposits in the kidney (nephrocalcinosis)
• Dehydration
• High blood pressure
• Kidney failure
• Kidney stones
• Depression
• Difficulty concentrating or thinking
• Bone cysts
• Fractures
• Osteoporosis

These complications of long-term hypercalcemia are uncommon today.

Treatment

Removal of the abnormal and hyperfunctioning parathyroid tissue results in a long-term cure of HPT in 96% of patients and significant improvement in associated symptoms. The following criteria were proposed as indications for parathyroidectomy based on a National Institutes of Health–sponsored panel and endocrine specialty societies –

• Serum Ca level more than 1 mg/dL above the upper limit of normal
• Marked hypercalciuria higher than 400 mg/day
• Creatinine clearance reduced more than 30% compared with age-matched controls
• Reduction in bone mineral density of the femoral neck, lumbar spine, or distal radius of more than 2.5 standard deviations below peak bone mass (T score lower than -2.5)
• Age younger than 50 years
• Patients for whom medical surveillance is not desirable or possible
• Presence of any complications (e.g., nephrolithiasis, overt bone disease)
• An episode of hypercalcemic crisis

Medications – In some cases, the doctor may recommend:

Calcimimetics – This type of drug mimics calcium circulating in the blood, so it can help control overactive parathyroid glands.

Bisphosphonates – Intravenous osteoporosis drugs can help rebuild bone weakened by hypercalcemia. Risks associated with this treatment include osteonecrosis of the jaw and certain types of thigh fractures.

Prednisone – If the hypercalcemia is caused by high levels of vitamin D, short-term use of steroid pills such as prednisone might be helpful.

IV fluids and diuretics – Extremely high calcium levels can be a medical emergency. Hospitalization for treatment with IV fluids and diuretics to promptly lower the calcium level may be needed to prevent heart rhythm problems or damage to the nervous system.

Dialysis – If the kidneys fail due to cancer or its treatment, you may need dialysis. Dialysis removes wastes from the blood when the kidneys don’t work properly.

Alternative Treatment

• Probiotics – Vitamin K2 (menaquinone) is one of many vitamins that probiotic microbes make in the digestive tract. If the bacteria in the gut are out of balance, people may be deficient in K2 and several other B vitamins. A deficiency of vitamin K2 causes deposition of calcium on the artery walls and atherosclerosis.
• Drink plenty of fluids, especially water – Drinking fluids can help keep the person from dehydration and help prevent kidney stones from forming.
• Exercise – Once the calcium levels return to normal, and if the person is otherwise healthy, it’s important to remain active to help maintain bone density. Try to combine strength training with weight-bearing exercises.
• Don’t smoke – Smoking has been shown to increase bone loss as well as dramatically increase the risk of a number of serious health problems.

Reference –

http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/managing-side-effects/increased-intracranial-pressure-icp/?region=on

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.457.692&rep=rep1&type=pdf\

http://www.mayoclinic.org/diseases-conditions/hypercalcemia/basics/treatment/con-20031513

http://www.globalhealingcenter.com/natural-health/what-is-calcium-toxicity-and-hypercalcemia/

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.457.692&rep=rep1&type=pdf\

http://www.dhhs.tas.gov.au/__data/assets/pdf_file/0009/36945/aaa_Hypercalcaemia_FINAL_021111.pdf

https://www.endocrinology.org/policy/docs/13-02_EmergencyGuidance-AcuteHypercalcaemia.pdf

http://www.healthcommunities.com/blood-disorders/what-is-hypercalcemia.shtml

https://umm.edu/health/medical/ency/articles/hypercalcemia

http://www.merriam-webster.com/dictionary/hypercalcemia

http://www.medicinenet.com/hypercalcemia/article.htm

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2967024/