ALCOHOLIC LIVER CIRRHOSIS

The liver is a large organ with an important job in your body. It filters the blood of toxins, breaks down proteins, and creates bile to help the body absorb fats. When a person drinks alcohol heavily over a long period (years), the body starts to replace the liver’s healthy tissue with scar tissue. This condition is called alcoholic liver cirrhosis.

As the disease progresses over time, more of the healthy liver tissue is replaced with scar tissues, this causes the liver to stop functioning properly.

According to research, between 10 and 20 percent of heavy drinkers will develop cirrhosis. Alcoholic liver cirrhosis is the most advanced form of liver disease that is related to drinking alcohol. The disease is part of a progression. It may start with fatty liver disease, then progress to alcoholic hepatitis, and then to alcoholic cirrhosis. However, it’s possible a person can develop alcoholic liver cirrhosis without ever having alcoholic hepatitis

CAUSES:

The main cause is damage from repeated and excessive alcohol abuse. When the liver tissue starts to scar, the liver doesn’t work as well as it did before. As a result, the body can’t produce enough proteins or filter toxins out of the blood as it should.

 Alcoholic liver cirrhosis is directly related to alcohol intake.

The National Institute on Alcohol Abuse and Alcoholism defines heavy drinking as drinking five or more drinks in one day on at least five of the past 30 days.

Women are more at-risk for alcoholic liver disease. Women don’t have as many enzymes in their stomachs to break down alcohol particles. Because of this, more alcohol is able to reach the liver and make scar tissue.

Alcoholic liver disease can also have some genetic factors. For example, some people are born with a deficiency in enzymes that help to eliminate alcohol. Obesity, a high-fat diet, and having hepatitis C can also increase a person’s likelihood they will have alcoholic liver disease.

SYMPTOMS:

The symptoms of alcoholic liver cirrhosis are similar to other alcohol-related liver disorders. Symptoms include:

·         jaundice

·         portal hypertension, which increases blood pressure in the vein that travels through the liver

·         skin itching (pruritus)

TREATMENT:

Doctors can reverse some forms of liver disease with treatment, but alcoholic liver cirrhosis usually can’t be reversed. However, a doctor can recommend treatments that may slow the disease’s progression and reduce the symptoms.

The first step in treatment is to help the person stop drinking. Those with alcoholic liver cirrhosis are often so dependent on alcohol that they could experience severe health complications if they try to quit without being in the hospital. A doctor can recommend a hospital or treatment facility where a person can start the journey toward sobriety.

Other treatments a doctor may use include:

·         Medications

·         Nutritional Counseling: Alcohol abuse can lead to malnutrition.

·         Extra protein: Patients often require extra protein in certain forms to help reduce the likelihood for developing brain disease.

·         Liver Transplant: A person often must be sober for at least six months before they are considered a candidate for liver transplant.

ELEPHANTIASIS AND MOSQUITOES

Elephantiasis is also known as lymphatic filariasis. It’s caused by parasitic worms and can spread from person to persons through mosquitoes. Elephantiasis causes swelling of the scrotum, legs, breasts, etc.

Elephantiasis is most common in tropical countries and is caused by parasitic nematode worms that look like tiny threads. The infection caused by these filarial worms, Wuchereria bancrofti, Brugia malayi and Brugia timori, are transmitted by mosquitoes. Fortunately, this infectious disease is very rare in Western countries. . It’s estimated that over 120 million people have elephantiasis. It has existed for a long time. Reports of the disease have been documented in ancient Greek literature. It was only in later centuries when a better understanding of elephantiasis was developed, pinpointing mosquitoes as carriers of the worms.

 It predominantly occurs mostly at the poor portions of the population, in areas where there are great numbers of breeding sites for mosquitoes that carry the disease. 

TRANSMISSION

Elephantiasis starts from the bite of an infected mosquito, or when a person comes into contact with water where the infected mosquitoes breed. The parasitic worms that are transferred to humans burrow into the body; the part of the body it burrows is the lymphatic systems.

Adult worms will live in the lymphatic vessels for 4 to 6 years, and the females can produce a large number of larvae (microfilariae) which travel around in the bloodstream. The infection can be spread when a mosquito that has bitten an infected person bites other people. In the areas where the disease is concentrated, it is estimated that 54% of the population are infected by microfilariae.

Although it is not fatal, elephantiasis is chronic and very painful. The disease causes an accumulation of fluid, swelling, passing of cloudy-colored urine, and in its most extreme form, the skin and underlying tissues of the lower limbs and scrotum thickens and become distended, taking on the resemblance of elephant limbs and earning it the name, elephantiasis. 

The inflammation that starts within the skin is usually caused by the immune system’s reaction to the parasite. It can also be caused by bacteria which may have invaded the skin because of an already weakened immune system.

These symptoms develop in a very slow manner, sometimes taking years. Those who are infected do not show any outward signs until the disease reaches its late phase. In the latter stage of the disease, affected persons are immediately identified because of their grossly swollen legs, arms, breasts or genitals with cracked, thickened skin that is rough and hard to the touch. Elephantiasis can also cause damage to the kidneys and the entire lymphatic system. People who are affected by elephantiasis are subjected to social stigma and are unable to live a normal life.

PREVENTION

Preventing the occurrence of lymphatic filariasis means avoiding the bites of mosquitoes suspected of carrying the disease. It’s advisable to limit outdoor activities during night-time, especially if living in rural areas or jungles; avoiding dark-colored clothing which is attractive to mosquitoes, not wearing scents like perfume or cologne, treating clothes with an insect repellent, using citronella or lemon eucalyptus leaves to ward off mosquitoes, installing screens and mosquito nets, using air-conditioning as cooler air causes mosquitoes to become lethargic and wearing of long sleeves and long pants to prevent mosquito bite.

TREATMENT

There is no vaccine for Elephantiasis as of the present; scientists are still working to find a preventive inoculation for the disease. The World Health Organization also continues its drive to stop the infection from spreading, and to ease the symptoms of those already infected.

Treatment for elephantiasis includes:

·         Use of anti parasitic drugs

·         Using good hygiene to clean the affected areas

·         Elevating the affected areas

·         Caring for wounds in the affected areas

·         Exercising based on a doctor’s directions

·         Surgery in extreme cases, which may include reconstructive surgery for the affected areas or surgery to remove affected lymphatic tissue

Treatment may also include emotional and psychological support.

COMPLICATIONS OF THE CONDITION

The most common complication of elephantiasis is disability caused by extreme swelling and enlargement of body parts. The pain and swelling can make it difficult to complete daily tasks or work. In addition, secondary infections are common concern with elephantiasis

Imagine having your legs and genital organs puff up to roughly the size of elephant limbs. Now imagine having to attend to your daily activities while attempting to move your huge and swollen body parts.

PELVIC INFLAMMATORY DISEASE (PID)

Pelvic inflammatory disease (PID) is an infection of a woman's reproductive organs. The pelvis is in the lower abdomen and includes the fallopian tubes, the ovaries, the cervix and the uterus.  Usually PID is caused by bacteria from sexually transmitted infections (STIs). Sometimes PID is caused by normal bacteria found in the vagina. If left untreated, PID can cause problems getting pregnant, problems during pregnancy, and long-term pelvic pain. PID affects about 10 million women each year globally.

Several different types of bacteria can cause PID, including the same bacteria that cause the sexually transmitted infections (STIs) gonorrhea and Chlamydia. What commonly occurs is that bacteria first enter the vagina and cause an infection. As time passes, this infection can move into the pelvic organs. PID can become extremely dangerous and life-threatening.

CHANCES OF HAVING PID

Your risk of pelvic inflammatory disease increases if you have a preexisting Sexually Transmitted Infection ie gonorrhea, Chlamydia etc. However, you can develop PID without ever having an STI. Other factors that can cause pelvic inflammatory disease include:

·         having sex and being under the age of 25

·         having multiple sex partners

·         having sex without a condom

·         using an intrauterine device (IUD) to prevent a pregnancy

·         douching

·         having a history of pelvic inflammatory disease

SYMPTOMS

Some women with pelvic inflammatory disease don’t have symptoms. For the women who do have symptoms, these can include:

·         pain in the lower abdomen (the most common symptom)

·         pain in the upper abdomen

·         fever

·         painful sex

·         painful urination

·         irregular bleeding

·         increased or foul-smelling vaginal discharge

·         tiredness

TREATMENT

Your doctor will prescribe some antibiotics to treat PID. Because your doctor may not know the type of bacteria that caused your infection, they may give you two different types of antibiotics to treat a variety of bacteria.

Within a few days of starting treatment, symptoms may improve or go away. It is strongly advised to finish your medication, even if you are feeling better. Stopping your medication early may cause reoccurrence.

Pelvic inflammatory disease may require surgery. This is rare most at times and only necessary if an abscess in your pelvis ruptures or the doctor suspects that an abscess will rupture. It can also be necessary if the infection does not respond to treatment.

The bacteria that cause PID can spread through sexual contact. If you are sexually active, your partner should also get treated for PID. Men may be silent carriers of bacteria that cause pelvic inflammatory disease. Your infection can recur if your partner doesn’t receive treatment. You may be asked to abstain from sexual intercourse until the infection has been resolved.

PREVENTION

You can lower your risk of PID by:

·         practicing safe sex

·         getting tested for sexually transmitted infections (STI’s)

·         avoiding douches

·         wiping from front to back after using the bathroom to stop bacteria from entering your vagina

VAGINAL DISCHARGE & YOUR HEALTH

Vaginal discharge serves as an important housekeeping function in the female reproductive system. Most often, it is perfectly normal and can vary from color and odour.

Hence Vaginal discharge can be seen as a fluid or mucus that comes out from a woman’s’ vagina.  It can also be seen as fluid or mucus that keeps the vagina moist, clean and protects it from infection. Fluid made by glands inside the vagina and cervix carries away dead cells and bacteria, this keeps the vagina clean and helps prevent infection.

Vaginal discharge is most often a normal and regular occurrence. However, there are certain discharges that can indicate an infection; there will be more discharge if you are ovulating, breastfeeding, or sexually aroused. The smell may be different if you are pregnant or you haven't been diligent about your personal hygiene.

None of those changes is a cause for alarm. However, if the color, smell, or consistency seems significantly unusual, especially if it is accompanied by vaginal itching or burning, it could be a sign of an infection or other condition. Abnormal discharge may be yellow or green, chunky in consistency, or have a foul odor.

CAUSES OF ABNORMAL DISCHARGE

Any change in the vagina's balance of normal bacteria/ normal flora, (Normal flora i.e. are microorganisms that colonize the vagina naturally) can affect the smell, color, or discharge texture. These are a few of the things that can upset that balance:

• Antibiotic or steroid use
• Bacterial vaginosis ( a bacterial infection more common in pregnant women or women who have multiple sexual partners)
• Birth control pills
• Cervical cancer
• Sexually Transmitted Infections (STD’S)
• Diabetes
• Douches , scented soaps or lotions, bubble bath
• Pelvic inflammatory disease (PID)
• Trichomoniasis ( a parasitic infection typically contracted and caused by having unprotected sex)
• Vaginal atrophy ( the thinning and drying out of the vaginal walls during menopause)
• Vaginitis, irritation in or around the vagina
• Yeast infections

TYPES OF VAGINAL DISCHARGE

There are several different types of vaginal discharge. Some types of discharge are normal while others may indicate an underlying condition that requires treatment. The amount of vaginal discharge varies among women and with the woman’s menstrual cycle. These types are categorized based on their color and consistency.

WHITE:

A bit of white discharge, especially at the beginning or end of your menstrual cycle, is normal. However, if the discharge is accompanied by itching and has a thick, cottage cheese-like consistency or appearance, it’s not normal and needs treatment. This type of discharge may be a sign of a yeast infection.

CLEAR AND WATERY:

A clear and watery discharge is perfectly normal. It can occur at any time of the month. It may be especially heavy after exercise.

CLEAR AND STRETCHY:

When discharge is clear but stretchy and mucous-like, rather than watery, it indicates that you are likely ovulating. This is a normal type of discharge.

BROWN AND BLOODY:

Brown or bloody discharge is usually normal, especially when it occurs during or right after your menstrual cycle. A late discharge at the end of your period can look brown instead of red. You may also experience a small amount of bloody discharge between periods. This is called spotting.

If spotting occurs during the normal time of your period and you’ve recently had sex without protection, this could be a sign of pregnancy. Spotting during an early phase of pregnancy can be a sign of miscarriage, so it should be discussed with your Obstetrician.

In rare cases, brown or bloody discharge can be a sign of advanced cervical cancer. This is why it’s important to get a yearly pelvic exam and Pap Smear. Your gynecologist will check for cervical abnormalities during these procedures.

YELLOW OR GREEN:

A yellow or green discharge, especially when it’s thick, chunky, or accompanied by an unpleasant smell is not normal. This type of discharge may be a sign of the bacterial infection. It’s commonly spread through sexual intercourse

DIAGNOSIS

Taking a health history and asking about symptoms. Questions may include:

• When did the abnormal discharge begin?
• What color is the discharge?
• Is there any smell?
• Do you have any itching, pain, or burning in or around the vagina?
• Do you have more than one sexual partner?
• Do you douche?

Sample of the discharge is taken or a Pap test to collect cells from your cervix for further examination.

TREATMENT

Treatment depends on the cause of the discharge. For example, yeast infections are usually treated with anti-fungal medications inserted into the vagina in cream or gel form.

 Bacterial Vaginosis is treated with antibiotic pills or creams.

PREVENTION

Here are some tips for preventing vaginal infections that can lead to abnormal discharge:

• Never use scented soaps and feminine products for your vagina.
• After using the convenience, always wipe from front to back to prevent bacteria from getting into the vagina and causing an infection.
• Wear 100% cotton underpants, and avoid overly tight undies.
• Do not wear a tampon. Tampons can introduce new germs to the vagina.
• Douching can lead to vagina infections
• Practice safe sex and use protection to avoid STIs.
• Try wearing a pad or panty liner that can help soak the excess moisture.
• Keep your outer genital area (vulva) clean and dry. It can help prevent some of the unpleasant odours that can possibly go along with vaginal discharge during pregnancy.

To decrease the likelihood of yeast infections when taking antibiotics, eat yogurt that contains live and active cultures. If you know you have a yeast infection, you can also treat it with an over-the-counter yeast infection cream or suppository.