Instant Natural Colic Relief
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Acute cholecystitis is an inflammatory condition of the gallbladder, often, but not always, associated with the presence of gallstones. It is a common surgical cause of emergency admission to hospital, and is more common in women than men in keeping with the distribution of stone disease. The symptoms will initially resemble biliary colic, with right upper quadrant pain, and nausea, but symptoms persist and patients become systemically unwell. Fever, tachycardia, and mild jaundice may develop, and the pain may radiate to the scapula. An initial chemical inflammation is often superceded by bacterial infection with a deterioration in systemic symptoms. Clinical examination demonstrates localised tenderness in the right upper quadrant over the fundus of the gallbladder. Pain on inspiration while palpating in the right
In cases of perineal locations, surgery will largely depend on whether or not a colostomy has to be performed. If intestinal resection requires a colostomy the decision is made automatically. More troublesome are the perineal infections where ongoing fecal drainage are at odds with wound management. Therefore colostomy is always to be considered as soon as an infection reaches the anal area58. The colostomy must be carried out in a healthy area to make sure neither the laparotomy scar nor the colostomy orifice become a causeway for the infection. The colic and rectal segment beyond the ostomy must be thoroughly emptied and cleaned. During the same surgical procedure, extensive drainage of the perineal infection must be carried in the same way, but quite separately from the colostomy.
Colorectal cancers may also result in intestinal obstruction necessitating stent placement to maintain the integrity of the visceral lumen. Occasionally a diverting colostomy will be required to bypass intestinal obstruction or fistula formation. If these procedures are not performed, intestinal colic can be palliated quickly with opioids. Opioids must be used carefully because they may worsen a partial bowel obstruction owing to their constipating effect. Anticholinergics like scopolamine, atropine, and loperamide also decrease peristalsis in the smooth muscle of the intestinal tract.
Renal problems occur particularly on indinavir treatment, and are caused by indina-vir crystals, which may be found in the urine of up to 20 of patients. Approximately 10 of patients develop nephrolithiasis, which is not visible on X-ray, accompanied by renal colic. Nephrolithiasis is primarily caused by high indinavir levels in relation to a low BMI, drug interactions and individual fluctuations of the drug plasma level. In one study, the intake of indinavir ritonavir 800 100 mg with a light meal reduced the indinavir plasma concentration, probably reflecting a food-induced delay in the absorption of indinavir (Aarnoutse 2003). In case of suspected high indinavir levels, therapeutic drug monitoring should be performed and the dose adjusted (Collin 2007). Interruption of therapy, following a single incidence of colic, is not usually necessary. More than 20 of patients have persistent asymptomatic leukocyturia associated with a gradual loss of renal function without urologi-cal...
Stomatitis and mucositis due to infection with Candida albicans is improved by an antifungal antibiotic such as keto-conazole or fluclonazole. Gastric distension can be relieved by metoclopramide and intestinal colic or an irritable bowel by anticholinergic antispasmodics such as dicyclomine. Corticosteroids may improve appetite and well-being.
A larger study that involved 30 women who were taking St. John's wort and breastfeeding compared results to women who were not taking St. John's wort. There were no differences in maternal events, including duration of breastfeeding, decreased lactation, or maternal demographics. Women taking St. John's wort did report a significantly higher level of infant side effects, such as lethargy and colic, vs one case of infant colic in 97 women not taking St. John's wort. None of these infants required medical attention (94).
Pain and tenderness in the kidney, because of their retroperi-toneal location, are felt posteriorly in the loin and renal angle. Pain from a stone passing from the renal pelvis down the ureter may be felt initially posteriorly. The pain then radiates around the loin into the iliac fossa and scrotum. Renal colic produces an intense, severe colicky type pain where the patient can find no relief by either movement or rest. In contrast, pain from a renal tumour or pyelonephritis is likely to be constant, but less intense.
This uncommon tumour may be associated with an existing bladder TCC. The condition may present as haematuria, 'clot colic' or be found incidentally, or during surveillance of a patient with known bladder cancer. Treatment for a localized tumour is nephroureterectomy. Metastatic disease is incurable and treated symptomatically.
Ureteric colic due to a stone passing down the ureter is one of the commonest urological emergencies. The severe pain must be distinguished from the pain of biliary colic or a ruptured abdominal aortic aneurysm (AAA) and therefore an IVU, or CT urogram, is needed to confirm the diagnosis and establish the level the stone has reached. Pain relief using NSAIDS or opiates is usually effective.
A leaking AAA is occasionally misdiagnosed as ureteric colic. Any patient over the age of 50 years with sudden onset of abdominal loin pain must not be diagnosed as having a symptomatic renal stone until radiological confirmation has been obtained, or an AAA excluded by ultrasonography.
The current rare occurrence of post-surgical or traumatic soft-tissue anaerobic infections demonstrates the effectiveness of preventive therapy. This is based on correct surgical care of the lesions combined with preventative antibiotic therapy by penicillin G - combined with imidazoles when the presence of Bacteroides sp is suspected (e.g., in colic or rectal lesions)97. However absolute prevention is not assured. Anaerobic infections can develop under antibiotic treatment - either because they have been provided too late or because surgery has been unable to restore antibiotic penetration due to vascular injury or compression, high compartmental pressures, devascularised tissue, contamination or foreign bodies remaining. In cases of particularly soiled wounds or late referrals, preventative therapy can combine preventative HBO (5 to 7 sessions over a period of 2 to 3 days) with antibiotic therapy. However, this reasonable but as yet empirical recommendation is not supported by...
The majority of cases (90 ) are idiopathic. The commonest ( 90 ) site of involvement is the ileocaecal region ileo-colic intussusception usually begins several centimeters proximal to the ileocaecal valve and advances into varying lengths of the colon, occasionally presenting at the rectum. Ileo-ileal and jejuno-jejunal intussusception may be secondary to a pathological lead point or previous surgery. In Africa, there is an increased incidence of colo-colic intussusception which tends to affect older children. The risk of intussusception lies in delayed diagnosis and treatment, which can result in bowel strangulation and perforation.
Gallstones may cause a variety of symptoms depending on which part of the body they are in. The commonest problems arise from stones in the gallbladder, and present as biliary colic or cholecystitis. Biliary colic is a self-limiting condition characterised by right upper quadrant pain, often severe, caused by temporary cystic duct obstruction. The pain is associated with nausea, and occasional vomiting, and may radiate to the back. If the pain does not settle within a few hours, and a fever and raised white cell count develop, then a diagnosis of acute cholecystitis is more likely (see Acute Cholecystitis). Unrelieved obstruction of the cystic duct may lead to formation of a muco-cele, as mucus secretions collect and produce a tense swollen gallbladder. Infection within an obstructed gallbladder results in an empyema. Stones in the CBD may cause obstructive jaundice (see Jaundice), as may stones impacted in Hartmann's pouch (Mirizzi's syndrome). Infection can occur within an...
Trichinosis is a zoonotic infection associated with the colonization of worms in muscles. It is often found in humans because of the consumption of uncooked or insufficiently cooked pork products (though other animals are also potential sources). Trichinella is the third most common worm that infects humans. They cause nausea, dysentery, puffy eyes, and colic. They also cause pain and more severe problems such as edema, cardiac and pulmonary problems, deafness, delirium, muscle pain, muted reflexes, nervous disorders, and pneumonia. Their natural hosts are flesh-eating animals, especially humans, pigs, rats, and other mammals. Humans are considered accidental hosts because, under normal conditions, the parasite ends its cycle that is, no other animals eat humans in order to transfer their larvae to other hosts. But concern for trichinosis is not as great today with improved pork production practices. Still, an estimated 5-6 million human infections are present at any one time in North...