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Acute pancreatitis

Pancreatitis are acute inflammation of the pancreas. There are acute and chronic forms of the disease. This section discusses the acute pancreatitis. This is defined as a sudden inflammation of the pancreas, which may occur once or several times.

Cause (s)

The cause of acute pancreatitis is that the digestive enzymes produced by the pancreas are already effective in the pancreas itself (rather than the gut) and attacking the tissue. It is practically self digestion of the body. Most commonly, acute pancreatitis is caused by gallstones.

Pancreatitis Hurt
Image courtesy of [marin] at FreeDigitalPhotos.net 

The excretory duct of gallbladder (ductus choledochus) joins together with the excretory duct of the pancreas (ductus pancreaticus) into the duodenum (duodenal). If gallstones are going down, they clog the Canal so that there is also a backlog of pancreatic secretion. Because where the bile also back can rise up, also a jaundice (jaundice) is possible.

Another common cause is the abuse of alcohol. Injury to the pancreas, infection (mumps and other diseases), errors in the fat metabolism or mineral balance, medication, vascular disease, birth defects or mechanical obstacles (tumor or stenosis of the mouth, scars, Ascaris) are rare.

History

The back pressure of fluid activates the enzymes that would normally secreted into the intestine in the wrong place. These enzymes to break down food components. The premature activation means that the pancreas cells are angedaut. Also blood vessels can be attacked and may cause bleeding. The body is lost through these processes much protein-rich fluid and blood, and can cause a State of shock.

Human Pancreas
Image courtesy of [dream designs] at FreeDigitalPhotos.net 

In addition, the activated enzymes in the bloodstream can transgress. They are distributed in the body and can cause damage to other organs. An irritation of the colon up to the paralytic ileus and a peritonitis arising in the abdominal cavity. In the pancreas itself, it comes to a tissue edema or necrosis.

The oedematous form is most common with 60 percent. In 30 percent of cases there are partial necrosis, in 10% of cases of complete necrosis. The more the necrosis are pronounced, the more complications occur and the higher the risk of pancreatitis is to die. After the acute phase, the cause of pancreatitis must be eliminated to prevent renewed inflammation (E.g. removal of the gallbladder, if the cause was gall stones).

Features

The acute pancreatitis presents itself as «acute stomach»: suddenly occurring severe pain in the upper abdomen (often belt-shaped with broadcasting in the back), vomiting, nausea, flatulence, flushed face. Heart palpitations, accelerated heart rate, blood pressure and weakness are signs of incipient shock. The patients are suffering, the belly is bulging elastic and gallstones. At simultaneous ileus, intestinal noises are reduced. The conjunctiva of the eye can be yellowish discoloration as an expression of an accompanying jaundice. The pancreatic enzymes are elevated in the blood serum alpha-amylase and lipase.

Diagnosis

Ultrasound: The pancreas is swollen; any gallstones are visible. If the ultrasound is not revealing enough, you can perform a CT scan with contrast. To exclude other possible causes of an acute abdomen, each creates an X-ray of chest and abdomen. Detection of bile stones an ERC occurs at an early stage. The course is harder, ever more necrosis and complications occur.

The edematous form without complications, the mortality rate is 5 percent. Partial necrosis and one or two complications, the mortality rate is already between 25 and 50 percent. With total necrosis and three until four complications the mortality rate rises to 80 to 100 percent. Survived the acute pancreatitis and the triggering cause removed, the disease heals normally. However, scars and cysts can remain and limit the function of the organ.

Complications

Possible complications of acute pancreatitis are numerous and feared:

1. Shock due to loss of fluids
2. Acute renal failure
3. Acute respiratory failure
4. Sepsis
5. Formation of abscess
6. Necrosis of adjacent organs
7. Bleeding in the gastrointestinal tract (blood, flowing from the pancreas in the intestine; Stress bleeding in the stomach)

Treatment

The treatment of acute pancreatitis must be in the hospital during heavy history even in the ICU because the patients need to be monitored carefully. The treatment is bed rest and ban on food and fluid intake. With vomiting, ileus, and complications, a feeding tube is placed. Patients receive antibiotics to painkillers, if necessary. With heavy gradients, an operation may be necessary to remove dead tissue.

When a patient with acute pancreatitis should eat again, is different. It starts slowly with tea and biscuits, followed by light fare (no fat, coffee, alcohol).

Hives: The right treatment

Avoid the triggers
The treatment of urticaria disease is carried out in different steps. In the first step, it should be trying to avoid the triggers of hives. This is however only possible, if the cause of hives is known: they caused, for example, by certain foods such as nuts or spices, these foods should not be eaten. With other triggers such as heat or cold, a complete avoid of the stimuli is hardly possible.

Antihistamines relieve the symptoms
Taking antihistamines represents the second step in the treatment of hives. They inhibit the secretion of histamine in the body and thereby relieve the common symptoms. Because histamine provides the water retention in the skin and the unpleasant itching. The cause of hives is not treated by the ingestion of antihistamines, however.
You should check the exact dosage of antihistamines - which is usually significantly higher than hay fever – always with your doctor. For chronic hives, the tablets often over several months must be taken to achieve success.

Only briefly take cortisone preparations
To achieve a fast relief of complaints also glucocorticoids such as cortisone can be taken after consultation with a physician in the third step instead of antihistamines. As well as the antihistamines, cortisone contributes to a reduction of symptoms of hives. However, cortisone preparations should be only for severe disease gradients and even then only briefly taken as they can have severe side effects.

Find the cause of hives
In addition to treating the symptoms the hives treatment should in particular aim to find the shutter release button and the cause of the disease. A first step is a detailed conversation with the attending physician in which the patient accurately describes in which situations the typical symptoms of hives occur.

Depending on the suspected, the doctor will perform several tests - such as an allergy test or a provocation test -. A disease is the cause of hives, the treatment must aim to cure the underlying disease or to improve the health status of the patient.

Is a physical stimulus of the trigger of hives, this can often not completely avoided in everyday life. Therefore, it is important as accurately as possible to get to know the trigger for those affected. Hives caused, for example, by pressure, need to find out whether and which body parts are particularly sensitive, and the pressure must be as strong for the typical symptoms.

Hives: avoid stress
Due to the many different causes of hives it not uncommon, that doctor and patient can identify not the trigger of the complaints. Then, it can be helpful to keep a hives Diary by one quoted, in which situations the disease occurs over a longer period. Also necessary to try to avoid potential triggers such as stress or psychological pressure.

Hives: Different types at a glance

Spontaneous hives

Typical symptoms occur in spontaneous hives suddenly and without first identifiable triggers such as itching, hives, and swelling of the skin. Depending on the duration of the skin rash will distinguish between acute and chronic hives: while an acute hives often but also already again subsides after two weeks - usually at the latest after a few hours -, one speaks of a chronic hives, if symptoms persist longer than six weeks. Often, no cause for the complaints can be found in chronic hives.

Physical hives

A physical hives triggered by external stimuli such as pressure, cold, light, friction or heat. Overall, there are over 20 different subtypes. In the following you will find the most famous:

1. Pressure hives: this form of hives cause pressure on specific body parts deep swelling. The swelling occurs most frequently on the back and on the soles of the feet and the palms of the hand.
2. Cold hives: cold hives can be triggered by cold air, cold water, or cold objects. As in other forms of urticaria also it comes to swelling and hives on the skin and mucous membranes. The symptoms are either a few minutes after the cold stimulus on or, but only then, when the body heats up again. The cold stimulus to trigger the typical symptoms of hives must be how big is different from person to person. Patients who suffer in cold hives, should always wear an emergency passport by the disease is noted. This is important for example in infusions, because sufferers administered only warmed up they get are allowed.
3. Light - hives: this form of hives is mostly caused by UV-A rays, in rare cases also through UV-B rays. In those places that have come with the rays in contact wheals form a short time later. The light urticaria is relatively rare.
4. Friction hives: approximately two to four percent of Germans suffer on friction - hives - the most common form of physical urticaria. The disease is caused by friction on the skin. The typical symptoms of hives can be caused for example by chafing of backpack carriers, but also by the friction of a T-shirt.
5. Heat hives: typical symptoms only occur when heat hives that have come with the heat source directly in contact. As well as light - hives also heat hives is extremely rare.

Cholinergische hives

Cholinergische hives is the most common special form of hives. It is triggered by a rise in body temperature and occurs especially in young adults. However, a cholinergic urticaria is rarely treated as occurring symptoms are usually weak. On average, this form of hives from two to ten years stops before it finally disappears.

Trigger of the cholinergic urticaria is an increase of in body temperature. This can be caused, for example, through sports, spicy foods, alcohol, fever, hot water, or emotional stress. The first hives can occur already during of the temperature rise. Mostly they disappear quickly, only in rare cases, they remain more than three hours.

How to contact with hives

Contact urticaria occurs only at the point that came with the release directly in contact. Triggers can be in a wide variety of substances: contact urticaria will, for example, often caused by LaTeX - in particular occupational groups, often wearing latex gloves, are affected. But also in the kitchen, contact urticaria is not a rare phenomenon: here the typical symptoms arise from contact with raw food, such as peeling potatoes or when manipulating fish.

It is particularly important to find the shutter of the complaints in the treatment of contact hives. This must be avoided then as far as possible in the future. This is not possible, antihistamines can be taken to suppress the unpleasant symptoms.

Hives: If the skin overreacts

Hives (urticaria) is a widespread in Germany hypersensitivity reaction of the skin. The disease shows symptoms such as redness, hives, as well as a severe itching. The causes and triggers of hives are diverse: be can they sparked among others by certain medications and foods, but also by pressure, heat and cold. In the treatment of hives is the search for the cause in the first place. Until it is found, treatment focuses on relieving symptoms.

Hives - a widespread rash

The hives - urticaria also called - includes atopic dermatitis and psoriasis to skin diseases most common in Central Europe. It is estimated that between 20 and 25 percent of the Germans at least once in their lives suffer from hives. The name derives (urtica) from the Latin word for nettle, because the symptoms are similar to skin reactions that occur after contact with a nettle.

The case of hives, the symptoms are caused by the neurotransmitter histamine. This is released by an incorrect reaction of the immune system on a really safe trigger in large quantities. Histamine increases the permeability of the blood vessels of the skin in the body and it comes to water retention in the DermIS - the hives.

Hives: Causes and triggers

The causes for the releases of the histamine are manifold, an allergy behind the complaints is about ten percent of the time. These can consist, for example, against certain foods or against drugs. In addition, virus diseases, infections with parasites, internal diseases, auto-immune diseases and infections in the nose ear neck-possible causes of hives can be.

In addition, hives can be triggered also by the following external stimuli:

1. Cold
2. Heat
3. Light
4. Friction
5. Pressure

Also psychological factors to can have an influence on the hives. It's considered to be relatively sure that stress can adversely affect an already existing hives. Whether stress as the sole cause of skin disease in question is still uncertain.

Hives is not contagious or hereditary, by the way. Only a special form of cold hives can be passed to the next generation. However, this form occurs extremely rarely.

Hives: typical symptoms

Typical symptoms of hives is a red rash, usually very itchy. The itching is often very stressful for those involved, because it is difficult to concentrate on other things and therefore also poor sleep. Characteristic is the feeling of those affected to be able to counteract the itching by pinching or pressure with your finger nails. This is different from other skin diseases such as Atopic Dermatitis, where sufferers more likely to attempt to relieve the itch by scratching hives.

In addition to itching, red swellings on the skin – are the so-called hives - another typical symptom of hives. The hives are sometimes stressful for those involved, because it can be disfiguring. They appear often initially as pinkish to red small surveys, which become larger over time.

The hives can occur only on certain body parts or to the entire body. Hiking this hives is especially typical for hives: disappear in one place and reappear in another.

Swelling in the revenge as life-threatening symptom

It often result in hives to swelling and water retention in subcutaneous tissue, the so called angioedema. In the rare case, also mucous membranes in the mouth, the throat and the throat of the swelling can be affected. This can cause life-threatening breathing problems. Sufferers have always an allergy emergency kit with them. In it, a liquid antihistamine, a liquid cortisone preparation, as well as a syringe of adrenaline should be included.

The individual symptoms of hives can occur very quickly - within a few minutes after contact with the shutter - or only after a few hours. Usually the symptoms subside 24 hours again after at the latest, in some cases, the hives are back after half an hour. During a burst of the nettle rash, the symptoms may occur but again after a short break. A batch of hives can last several days or even weeks.

Hives in children

Not only adults, but also children can be affected by hives. However, the skin disease occurs rather rarely in children. Adults are mainly affected above all by chronic hives.

Also in children, hives shows the typical symptoms such as red welts and severe itching. In babies and toddlers a hives thrust stops frequently just a few days, then the disease will disappear by itself. Otherwise a child or a dermatologist should be consulted, to determine the cause of the complaints.

Most frequently, an expired virus infection behind the hives is in small children. But also an allergy to certain foods or medications, as well as heat can cause unpleasant symptoms.

Hives and pregnancy

During pregnancy, the hives symptoms improve frequently, because the immune system is dampened. Some women also report a worsening of the disease. Also a hives can be triggered by the strong hormonal changes during pregnancy also for the first time.

Stronger gradients of disease in pregnant women can be problematic, since many medications against hives during pregnancy is not allowed.

Different types of hives

Hives is a very complex disease, different subtypes are distinguished:

1. Spontaneous hives
2. Physical hives
3. Cholinergische hives
4. How to contact with hives

When these subtypes, the hives is divided according to their duration or the trigger of the disease. Learn more about the different types of hives on the next page of the book.

Shingles

The shingles can occur at any age, afflicts but mostly people beyond the middle of life. The virus (varicella zoster) that triggers the shingles causes the chicken pox during childhood and then hidden remains in the nerve pathways. Under certain conditions it can be reactivated again - there is a shingles. The shingles - the specialist talks about herpes zoster - is an acute, restricted to certain regions of the infection that goes hand in hand with highly infectious blisters and pain.

Primary infection with the varicella-zoster virus is usually in childhood and manifests itself as a strong itchy chicken pox. Because the viruses are very infectious, the infection rate is very high: 94 percent of the population have been through this infection after the eleventh year of life.

The chicken pox after overcoming illness but not completely disappear from the body. Some remain so to speak "asleep" and held by the immune system in check – for life in the ganglion cells of the neural pathways. Under certain conditions, the virus can be reactivated and cause the unpleasant shingles. Depending on which nerves are affected, the Zoster infection moves one side of the spinal cord to the body, hence the name shingles.

Shingles: Symptoms and causes

The causes of a reactivation of the virus are usually unknown, but it seems that the immune status is reduced with age or such as severe stress - the virus can then walk back along the nerves in the skin and cause shingles. Where the infection is noticeable first as a burning, itchy, or stinging pain.

The typical rash appears as one of the symptoms until later - about 1-3 days after the virus reaches the skin. This rash is composed of red spots on the skin and small vesicles containing a virus-loaded, infectious liquid. The acute phase of the disease when shingles can have following symptoms: fatigue, headache, and fever. After another 3 to 5 days the sores break open and form scabs that fall off after 2 to 3 weeks gradually. A shingles heals off again without consequences in most cases.

Shingles: early start treatment

The early treatment of shingles is important to the virus as early as possible to curb and prevent further damage to the nerves - the so called post herpetic neuralgia. Is over 50 and infestation in the head or neck area missed early treatment can cause for months persistent chronic pain. Therefore if you suspect a shingles promptly for treatment seek medical attention.

The immediately derived acute treatment consists of two pillars. From the medication with anti-virals, on the other, the consistent treatment of pain caused by the shingles. A rapid inhibition of virus is required to avoid complications of shingles. Fast pain relief can help prevent a post-zosterischen neuralgia as a result of shingles in the first few days.

Shingles: Postzosterische neuralgia (PZN)

Especially older people can feel pain in places affected by shingles still months or even years that are difficult to treat and can chronifizieren. One speaks then no longer shingles, but a post-zosterischen neuralgia (PZN). Are the pain become chronic once, so they can be often still heavily influence.

The risk for this complication as a result of shingles increases with age. After a rule of thumb, the age is equivalent to approximately the percentage risk. A post-zosterische neuralgia (PZN) may persist in the worst case even for life and is unbearable for the affected part.

Occupied tongue

Our tongue is essential for the talk, taste and swallowing. On the tongue is also seen, whether or not our body is healthy: the tongue is busy, burns and hurts them or is swollen, this can provide an important indication of a physical disease. We explain how a healthy tongue should look, what is behind a white, yellow or brown coating of the tongue and what you can do if your tongue hurts or is swollen

Function of the tongue

The tongue has several important functions for humans. First of all, it plays an important role at dinner: This ensures that that the food in the mouth moves. As a result, the food can be crushed and eingespeichelt. Swallowing makes the tongue then sure that dehydrated food into the mouth is pushed.

But the tongue is not only for the processing of food, but also for the taste of importance: total distinguish five kinds of taste: sweet, sour, bitter, salty and unami - that means as much as hearty and savory. Today, we know that there are no fixed areas of taste. However, the different flavours in certain areas are perceived particularly strong:

1. Sweet on the tip of the tongue
2. Sour and salty at the edges of the tongue
3. Bitter at the back of the tongue
4. UNAMI in the middle of the tongue

In addition to tasting and swallowing the tongue for speaking is essential. Because many sounds could not be formed without the help of the tongue. So the quality of the debate is about in Parkinson's patients, will decrease the mobility of the tongue in the course of time often.

Tongue and health

Our tongue reflects the State of health of our body: a disorder is present, this not infrequently is on the tongue to detect. It is therefore important that you regularly check your tongue - best to present a mirror with daylight.

Ideally, check the condition of your tongue right in the morning after getting up, before you brush your teeth or drink a cup of coffee. Check whether changes in the color or the shape you notice. If you discover something worrying you a doctor - at best a general practitioner or a dentist.

If the tongue is

In the healthy condition, our tongue is pale red, smooth and moist. It is covered with a thin white layer, which consists of bacteria, food residues and old cells. At dinner, or through a careful oral hygiene this deposit is usually rubbed off.

The tongue is strong, this indicates mostly a disease of the body. Depending on the color of the tongue coating are different diseases in question:

1. White tongue coating: A thick, white tongue coating frequently suggests on gastro-intestinal problems. It can occur in the context of a cold. The white covering only right and left of the Middle Channel, is also a disorder of the pancreas can be the cause.
2. Yellowish surface of the tongue: the tongue is slightly yellowish, is probably a fungal infection of the trigger. A furry feeling in the mouth often occurs in additionally. Slightly stronger yellows can, however, indicate a disorder of the biliary or liver.
3. Red tongue coating (Himbeerzunge): A red tongue in infectious diseases such as Scarlet fever occurs frequently. Typically, the tongue is then small Thickenings. Other symptoms such as headache, abdominal pain, or pain in the area of the ribs, also a disease of the gastro-intestinal tract, the liver or the heart may be the cause. Burns the tongue Additionally, this indicates an inflammation of the tongue. In addition, it is also conceivable that the red tongue is caused by a vitamin B-12 deficiency.
4. Brown tongue coating: A Brown coating of the tongue is raised mostly by errors in the intestine. Is the tongue Additionally swollen, also a kidney weakness may be the cause. A brownish coating on the tongue can be caused but also by certain foods or pleasure poisons.
5. Gray surface of the tongue: the tongue is greyish discoloration, this may indicate an iron deficiency or an anaemia.
6. Black tongue coating: A black tongue coating is also referred to as 'Hairy', because the tongue by a change of tongue papillae looks like hairy. Such a surface can occur as a side effect of treatment with antibiotics. In addition, a hairy tongue can indicate but also on serious diseases, which go hand in hand with a significant weakening of the immune system.