IRRITABLE BOWEL SYNDROME

What Is Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS), also known as "spastic colon," is a common disorder. While most people experience digestive troubles once in a while, what sets IBS apart is belly pain and diarrhoea or constipation that comes back again and again. 

Symptoms of IBS
The main symptoms of IBS are abdominal pain accompanied by a change in bowel habits. This can include constipation, diarrhoea, or both. Gas and a visibly bloated belly are also common. The condition does not damage the digestive system, but persistent pain and frequent trips to the bathroom can interfere with everyday life.


Causes of IBS
Doctors don't know the exact cause of IBS. One theory is that the signals between the brain and intestines are somehow disrupted. This miscommunication may cause abnormal intestinal muscle contractions (seen on the right) that result in cramping, pain, and fluctuations in the speed of digestion. Patients have no sign of inflamed or damaged tissue or structural abnormalities in the digestive tract.

Who can get IBS?
Anyone can get IBS, but the condition is twice as common in women as in men. It's also more likely to affect people who have a family history of IBS. Symptoms usually begin when people are in their late 20s. It's uncommon for people over 50 to develop IBS for the first time. IBS sometimes co-exists with depression or anxiety.

Diagnosis
There is no standard test to check for IBS. Doctors usually make a diagnosis based on a patient's description of the symptoms. For this reason, it's important to be candid and specific about the problems you are having. Your doctor may order tests to rule out other causes of your symptoms.

Effects of IBS on Daily Life
IBS may not put your life at risk, but it can take a significant toll on your lifestyle. During episodes of frequent, urgent diarrhoea  you may find it difficult to commute to work or travel by air. You may find it necessary to map out bathrooms before going any place new. In severe cases, patients may become hesitant to eat out, see a movie, or socialize.

IBS and Stress

Whether you have IBS or not, you're probably familiar with the "butterflies in the stomach" that accompany public speaking, a college final, or other high-stakes events. Stress may trigger or worsen symptoms of IBS. This means that stress can be particularly problematic for people with IBS. IBS symptoms can cause stress, and stress can make the symptoms worse, leading to a vicious cycle.

What Triggers IBS?

The first step toward managing IBS is to identify what makes your symptoms worse. Besides stress, common triggers include eating a meal, hormonal changes, and certain medications. It's important to note that no specific foods have been universally linked to IBS symptoms. But keeping a food diary may help you pinpoint which foods are a problem for you.

 How Diet Changes Helps

Your treatment strategy will depend on your specific symptoms and triggers, but many people start with diet changes. You may find it helpful to avoid caffeine, alcohol, and fatty foods. Getting more fibre or water may also improve symptoms. Suspicious foods can be eliminated one at a time. It may take some trial and error to discover which changes provide the most relief.

Probiotics

Probiotics are friendly bacteria that help reduce the growth of harmful organisms in the digestive tract. There are many kinds of probiotics, but the best known is the type found in yoghurt -- look for a label that says "active cultures." Some studies suggest probiotics may reduce the occurrence of diarrhoea  but more research is needed to determine whether this includes symptoms caused by IBS.

Antidepressants and Antispasmodics
If a doctor prescribes antidepressants for IBS, this does not suggest your symptoms are "all in your head" or caused by depression. Antidepressants act on the chemical messengers in the digestive tract and can ward off pain and cramping. Antispasmodics may also be useful if cramping is a major symptom. Most medications have side effects, so be sure to discuss the pros and cons with your doctor.

Peppermint Oil

If you prefer a natural remedy, peppermint oil is worth a try. Studies suggest that it may be effective in relieving IBS symptoms. In fact, it performed better than a placebo at relieving symptoms in some people with IBS. Look for enteric-coated capsules, which are less likely to cause heartburn -- and check with your doctor first if you're taking other medications.

Psychotherapy

Because stress is known to make IBS worse, stress management can be highly beneficial. Cognitive-behavioural therapy is a form of psychotherapy that helps you replace negative thoughts with more positive or realistic ones. This can reduce stress, which in turn, reduces the pain and digestive symptoms associated with IBS. Therapy can also help you learn coping strategies for when your symptoms do flare up.

Biofeedback

Biofeedback teaches patients to recognize and change their body's response to stress. After a few sessions, many people are able to slow down their heart rate and enter a more relaxed state. This can be useful in relieving both the stress and symptoms of IBS.

Relaxation Therapy

Many people can learn to calm themselves through meditation, guided imagery, deep breathing, or other relaxation therapies. Studies suggest these techniques can help with a variety of IBS symptoms, including pain, diarrhoea  and constipation. With practice, it's possible to use relaxation techniques just about anywhere.

Long-Term Prognosis

IBS is a chronic condition, and patients may experience quieter periods followed by flare-ups. Keeping a personal diary of food, feelings, and symptoms can help uncover hidden triggers when people are first diagnosed -- and if IBS begins to interfere with daily life again. Over time, the symptoms of IBS typically do not get worse. IBS is not life-threatening and does not lead to more serious conditions, such as inflammatory bowel disease or cancer.



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Migraine- causes, triggers, treatment, alternate therpaies

What Is a Migraine?

A migraine is a headache with throbbing pain that is usually worse on one side of the head. The pain is often severe enough to hamper daily activities and may last from four hours to three days if untreated. More than one in 10 Americans, including one in 6 women, have migraines, but many have been told mistakenly that they have a sinus or tension headache. Foods, stress, and hormones can be migraine triggers.

Migraine Symptoms
Throbbing pain typically occurs on one side near the temples, forehead, and eyes. Migraines can make you very sensitive to light, sound, or mild exertion, such as climbing the stairs. Many people have nausea, vomiting, or vision problems. The pain can be disabling, forcing people to miss work or other activities.

Migraine With Aura
About 20% of people who suffer from migraines will have an aura about 20 minutes to an hour before the pain. They may see flashing lights, wavy lines, or dots, or they may have blurry vision or blind spots. These are called "classic migraines."

Migraine Warning Signs
Some people may have a change in mood before a migraine begins. They may become more excitable or irritable or depressed. Others may detect a sensation, such as a funny smell or taste. They may feel more fatigued, yawn frequently, or experience muscle tension. About 1 in 4 people experience this prodrome phase, which can occur as early as 24 hours before any head pain.

What Causes a Migraine?
The exact cause of migraines is still not well understood, but the problem is considered to be neurological (related to the nervous system). It is believed that  brain chemicals, blood vessels, and nerves of the brain are involved.

 What Triggers Migraine

1) Flashing Lights
Migraines may be set off by some specific cause, such as flickering lights. This could be a reflection from snow or water or from fluorescent bulbs or television or movie screens. Wearing polarizing sunglasses outside and using daylight spectrum fluorescent bulbs inside may help.

2) Anxiety and Stress
Emotional stress is a common trigger of migraines. While it's impossible to completely avoid stress, relaxation exercises can help you cope. Inhale and exhale slowly, letting the air fill you and then deflate like a balloon. Some people find that thinking of a peaceful scene or listening to favourite music can help.

3) Lack of Food or Sleep
It's important for people prone to migraines to have a regular pattern of meals and sleep. Low blood sugar from skipping meals can trigger a migraine. Eating too much sugar also can cause a spike, then a "crash" in blood sugar. Drink water throughout the day to avoid dehydration and sleep at least six to eight hours a night.

4) Hormonal Changes
For many women, migraines are tied to their menstrual cycle, occurring either a few days before or during their period, when estrogen levels drop. Some women may benefit from anti-inflammatory medication before their headaches begin, or hormonal birth control such as pills, patches, or rings. Others may have no benefit or worse migraines with hormonal birth control.

5)  Foods That Trigger Headache
Migraine sufferers often report that certain foods trigger their headaches. Common culprits include MSG, red wine, cheese, chocolate, soy sauce, and processed meats. However, scientific studies haven't confirmed any particular food as a migraine trigger.

6) Tyramine
Aged, fermented, and stored foods have higher levels of tyramine, a substance created from the breakdown of the amino acid tyrosine. Tyramine may cause blood vessels to constrict then expand, and it may be a trigger for some migraines. Some headache experts advise limiting fermented or aged foods, such as cheese, soy sauce, pickles, and pepperoni.

Does Caffeine Help?
When combined with some pain medications, caffeine can help provide relief. Most migraine sufferers can drink a cup or two a day of coffee without any problems. However, too much caffeine can lead to headaches when the stimulant effect wears off.

Track Personal Triggers
Find out what triggers your migraines by keeping a headache diary. Each time you suffer from a migraine, make a note about the warning signs (the "prodrome"), triggers, and severity. If you can discover some of your personal triggers, you may be able to avoid future headaches.

Common Victims of Migraine ?
Women are three times more likely to have migraines than men. If you have a close relative with migraines, you are much more likely to have migraines, too. Experts believe migraines may be related to mutations in genes that affect certain areas of the brain. Migraine is also more common among people who have epilepsy, depression, asthma, anxiety, stroke, and some other neurologic and hereditary disorders.

Migraines in Children
About 5% of the children with headache problems suffer from migraines. Both boys and girls can get migraines, but after puberty they are more common among girls. Children may have symptoms other than headache, including stomach pain (abdominal migraine) or forceful and frequent vomiting (cyclic vomiting). If young children become wobbly on their feet, pale, and fussy, or have involuntary eye movements or vomiting, they may have a form of migraine called benign paroxysmal vertigo.

Diagnosing Migraine
Migraines are diagnosed primarily from symptoms, but your doctor may want to do a brain scan to rule out other causes of your headache, such as a brain tumor or bleeding in the brain. A CT scan uses special X-rays to create cross-sectional images of the brain.  An MRI uses radio frequency pulses and a magnetic field to create images of the brain.

Calculating Your Headache Burden
Before you begin treatment, your doctor may want to assess your "headache burden" -- how much your life is affected by your migraines. A simple questionnaire asks how many times you have missed work, school, or family or leisure activities because of your migraines.

Treatments: 
1) Over-the-Counter Drugs
Combinations of common pain relievers and anti-inflammatories may help: aspirin, naproxen sodium, ibuprofen, acetaminophen. Some have been formulated specifically to treat migraines. However, overuse may actually make headaches worse or may lead to ulcers or other gastrointestinal problems.

2) Triptans
Triptans, the most common medication prescribed for migraines, are most effective when taken early in an attack. Common triptans include Amerge, Axert, Frova, Imitrex, Maxalt, Relpax, Treximet, and Zomig. People with high blood pressure, heart disease, stroke, and other conditions may not be able to take triptans. And because of possible serious drug interactions, you should talk to your doctor about other medications you take such as antidepressant or antiseizure medicine. Side effects of triptans include nausea, dizziness, tingling, numbness, and chest pain.

3) Ergotamines
If triptans don't give you relief, your doctor may prescribe dihydroergotamine (Migranal) or ergotamines (Cafergot or Migergot) as tablets, nasal sprays, or injections. These drugs narrow the blood vessels and can cause nausea, dizziness, muscle pain, or a bad taste in the mouth. They are not usually as effective as triptans and also have some interactions with other drugs.

4) Preventive Medicines
If your migraines are frequent or very severe, you may need to take a medicine every day to prevent attacks. Timolol (Blocadren), divalproex sodium (Depakote), propranolol (Inderal), and topiramate (Topamax) are common, approved preventive medicines. They are drugs that were designed to treat high blood pressure or to prevent seizures.

 Analyse If Your Treatment Is Working?
After you have treated two or three headaches, ask yourself some simple questions. Are you getting the relief you need? If not, you should ask your doctor about altering the treatment. Be sure you take your medications early in the attack -- at least within two hours of migraine pain.

Don't Misuse Medication 
Overuse of medications can sometimes lead to chronic headaches. You shouldn't take prescribed medicines more than two times per week. You can get rid of the chronic headaches by tapering and discontinuing your medication – under a doctor's supervision. Pain medicines containing narcotics should be taken only when other medications fail to relieve pain because they can be habit-forming.

Alternative Therapies:

1) Biofeedback
Biofeedback and relaxation training can give you relief that is similar to the help you get from medications. Biofeedback uses a monitor to train you to recognize the onset of muscle tension and changes in body temperature that are signals of stress.

2) Acupuncture
Acupuncture is a form of Chinese medicine that uses very fine needles inserted in specific spots to balance the body's energy flow. Some researchers have found acupuncture causes the brain to release chemicals that affect pain. However, studies on the effectiveness of acupuncture for migraine symptoms has been mixed.

When You Need Immediate Attention
Any new headache that is unusually severe or lasts more than a couple of days should be checked by a doctor. It's also important to let your health care provider know if the pattern of your headaches changes -- for example, if there are new triggers. If you have a headache accompanied by paralysis, confusion, fever, or stiff neck, seek emergency medical care.