Burning mouth syndrome

Burning mouth syndrome

Definition:
Burning mouth syndrome causes chronic burning pain in your mouth. The pain from burning mouth syndrome may affect your tongue, gums, lips, inside of your cheeks, roof of your mouth, or widespread areas of your whole mouth. The pain can be severe, as if you scalded your mouth.

Unfortunately, the cause of burning mouth syndrome often can't be determined. Although that makes treatment more difficult, don't despair. By working closely with your health care team, you can usually get burning mouth syndrome under control.

Other names for burning mouth syndrome include scalded mouth syndrome, burning tongue syndrome, burning lips syndrome, glossodynia and stomatodynia.

Burning mouth syndrome:
Symptoms of burning mouth syndrome include:

• A burning sensation that may affect your tongue, lips, gums, palate, throat or whole mouth
• A tingling or numb sensation in your mouth or on the tip of your tongue
• Mouth pain that worsens as the day progresses
• A sensation of dry mouth
• Increased thirst
• Sore mouth
• Loss of taste
• Taste changes, such as a bitter or metallic taste

The pain from burning mouth syndrome typically has several different patterns. It may occur every day, with little pain when you wake but becoming worse as the day progresses. Or it may start as soon as you wake up and last all day. Or pain may come and go, and you may even have some entirely pain-free days.
Whatever pattern of mouth pain you have, burning mouth syndrome may last for years. In some cases, though, symptoms may suddenly go away on their own or become less frequent. Burning mouth syndrome usually doesn't cause any noticeable physical changes to your tongue or mouth.

When to see a doctor
If you have pain or soreness of your tongue, lips, gums or other areas of your mouth, see your doctor or dentist as soon as possible. They may need to work together to help pinpoint a cause and develop an effective treatment

Causes:
The cause of burning mouth syndrome can be classified as either primary or secondary.

Primary burning mouth syndrome
When the cause of burning mouth syndrome isn't known, the condition is called primary or idiopathic burning mouth syndrome. Some research suggests that primary burning mouth syndrome is related to problems with taste and sensory nerves of the peripheral or central nervous system.

Secondary burning mouth syndrome
Sometimes burning mouth syndrome is caused by an underlying medical condition, such as a nutritional deficiency. In these cases, it's called secondary burning mouth syndrome.
Underlying problems that may be linked to secondary burning mouth syndrome include:

• Dry mouth (xerostomia), which can be caused by various medications or health problems.
• Other oral conditions, such as oral yeast infection (thrush), oral lichen planus or geographic tongue.
• Psychological factors, such as anxiety, depression or excessive health worries.
• Nutritional deficiencies, such as lack of iron, zinc, folate (vitamin B-9), thiamin (vitamin B-1), riboflavin (vitamin B-2), pyridoxine (vitamin B-6) and cobalamin (vitamin B-12).
• Dentures. Dentures can place stress on some of the muscles and tissues of your mouth, causing mouth pain. The materials used in dentures also can irritate the tissues in your mouth.
• Nerve damage to nerves that control taste and pain in the tongue.
• Allergies or reactions to foods, food flavorings, other food additives, fragrances, dyes or other substances.
• Reflux of stomach acid (gastroesophageal reflux disease) that enters your mouth from your upper gastrointestinal tract.
• Certain medications, particularly high blood pressure medications called angiotensin-converting enzyme (ACE) inhibitors.
• Oral habits, such as tongue thrusting and teeth grinding (bruxism).
• Endocrine disorders, such as diabetes and underactive thyroid (hypothyroidism).
• Hormonal imbalances, such as those associated with menopause.
• Excessive mouth irritation, which may result from overbrushing of your tongue, overuse of mouthwashes or having too many acidic drinks.

Complications:
Complications that burning mouth syndrome may cause or be associated with are mainly related to pain and include:

• Difficulty sleeping
• Irritability
• Depression
• Anxiety
• Difficulty eating
• Decreased socializing
• Impaired relationships

Treatments and drugs:

There's no one sure way to treat primary burning mouth syndrome, and solid research on the most effective methods is lacking. Treatment depends on your particular signs and symptoms, as well as any underlying conditions that may be causing your mouth pain. That's why it's important to try to pinpoint the cause. Once any underlying causes are treated, your burning mouth syndrome symptoms should get better.

If a cause can't be found, treatment can be challenging. There's no known cure for primary burning mouth syndrome. You may need to try several treatment methods before finding one or a combination that is helpful in reducing your mouth pain. Treatment options may include:

• A lozenge-type form of the anticonvulsant medication clonazepam (Klonopin)
• Alpha-lipoic acid, a strong antioxidant produced naturally by the body
• Oral thrush medications
• Certain antidepressants
• B vitamins
• Cognitive behavioral therapy
• Specific oral rinses or mouthwashes
• Saliva replacement products
• Capsaicin, a pain reliever that comes from chili peppers

Surgery isn't recommended for burning mouth syndrome.

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Blood donation

Blood donation

Definition:
Blood donation is a voluntary procedure. You agree to have blood drawn so that it can be given to someone who needs a blood transfusion. Millions of people need blood transfusions each year. Some may need blood during surgery. Others depend on it after an accident or because they have a disease that requires blood components. Blood donation makes all of this possible.
There are several types of blood donation:

• Whole blood. This is the most common type of blood donation, during which approximately a pint of whole blood is given. The blood is then separated into its components — red cells, plasma, platelets.
• Platelets. This type of donation uses a process called apheresis. During apheresis, the donor is hooked up to a machine that collects the platelets and some of the plasma, and then returns the rest of the blood to the donor.
• Plasma. Plasma may be collected simultaneously with a platelet donation or it may be collected without collecting platelets during an apheresis donation.
• Double red cells. Double red cell donation is also done using apheresis. In this case, only the red cells are collected.

To be eligible to donate whole blood, platelets or plasma, you must be:

• In good health
• At least 17 years old — the minimum age varies by state with some states allowing 16-year-olds to donate with parent permission; there's no upper age limit
• At least 110 pounds
• Able to pass the physical and health history assessments

The eligibility requirements are slightly different for double red cell donation. Check with your local donor center for specifics.

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Blocked tear duct

Blocked tear duct

Definition:
When you have a blocked tear duct, your tears can't drain normally, leaving you with a watery, irritated eye. Blocked tear ducts are caused by a partial or complete obstruction in the tear drainage system.

As many as 20 percent of newborn babies have a blocked tear duct at birth, but it usually clears up on its own in the first year of life. Adults can get a blocked tear duct as a result of an infection, inflammation, an injury or a tumor. A blocked tear duct almost always is correctable, but the treatment depends on the cause and your age.

Symptoms:
Signs and symptoms may be caused by the blocked tear duct or from an infection that develops because of the blockage. Look for:

• Excessive tearing
• Watery eyes
• Recurrent eye inflammation (conjunctivitis)
• Recurrent eye infections (dacryocystitis)
• Painful swelling of the inside corner of the eye
• Eye mucus discharge
• Blurred vision
• Bloody tears

When to see a doctor
If your eye has been watery and leaking or is continually irritated or infected, make an appointment to see your doctor. Some blocked tear ducts are caused by tumors pressing on the tear drainage system, and quick identification of the tumor can give you more treatment options.

Causes:
Most of your tears come from your lacrimal glands, which are located above each eye. The tears flow down the surface of your eye to lubricate and protect it, and then drain into tiny holes (puncta) in the corners of your upper and lower eyelids. The tears then travel through the small canals in the lids (canaliculi) to a sac where the lids are attached to the side of the nose (lacrimal sac), then down a duct (the nasolacrimal duct) before emptying into your nose, where they evaporate or are reabsorbed. A blockage can occur at any point in the tear drainage system, from the puncta to your nose. When that happens, your tears don't drain properly, giving you watery eyes and increasing your risk of eye infections and inflammation.

Blocked tear ducts can be present at birth (congenital) or can occur at any other age. Causes include:

• Congenital blockage. As many as 20 percent of all newborns have a blocked tear duct. In these instances, the tear drainage system may not be fully developed or there may be a duct abnormality. A thin tissue membrane often remains over the opening that empties into the nose (nasolacrimal duct) in congenitally blocked tear ducts. This usually opens spontaneously during the first or second month of life.
• Abnormal development of the skull and face (craniofacial abnormalities). The presence of craniofacial abnormalities, including those in certain disorders such as Down syndrome, increases the likelihood of blockage of the tear ducts.
• Age-related changes. Older adults may experience age-related changes that can cause blocked tear ducts, including narrowing of the punctal openings.
• Eye infections or inflammation. Chronic infections and inflammation of your eyes, tear drainage system or nose can cause your tear ducts to become blocked.
• Facial injuries or trauma. An injury to your face can cause bone damage near the drainage system and disrupt the normal flow of tears through the ducts.
• Tumors. Nasal, sinus or lacrimal sac tumors can occur along the tear drainage system, blocking it as they grow larger.
• Cysts or stones. Sometimes, cysts and stones form in the tear drainage system, creating blockages.
• Topical medications. Rarely, long-term use of certain topical medications, such as those that treat glaucoma, can cause a blocked tear duct.
• Other medications. A blocked tear duct is a possible side effect of docetaxel (Taxotere), a commonly used chemotherapy medication for breast or lung cancer.

Complications:
Because your tears aren't draining the way they should, the tears that remain in the drainage system become stagnant, promoting growth of bacteria, viruses and fungi. These organisms can lead to recurrent eye infections and inflammation. Any part of the tear drainage system, including the clear membrane over your eye surface (conjunctiva), can become infected or inflamed because of a blocked tear duct. 

Treatments and drugs :

The cause of your blocked tear duct will determine which treatment is right for you. Sometimes, more than one treatment or procedure is needed before a blocked tear duct is completely corrected.
If an infection is suspected, your doctor will likely prescribe antibiotics.
If a tumor is causing your blocked tear duct, treatment will focus on the cause of the tumor. Surgery may be performed to remove the tumor, or your doctor may recommend using other treatments to shrink it.
Treatment options for non-tumor-blocked tear ducts vary from simple observation to surgery.

Conservative treatment
A high percentage of infants with congenital blocked tear duct improve on their own in the first several months of life, after the drainage system matures or the extra membrane involving the nasolacrimal duct opens up.

If your infant's blocked tear duct isn't opening on its own, your doctor may recommend that you use a special massage technique to help open up the membrane covering the lower opening into your baby's nose. Ask your doctor to show you how to perform this massage.

Conservative treatment may be recommended if the tear ducts become blocked from tissue swelling after facial injury. In most cases of blocked tear ducts after such facial trauma, the drainage system starts functioning again on its own a few months after the injury, and no further treatment is needed. Your doctor may recommend waiting three to six months after your injury before considering surgical intervention to open a blocked tear duct.

Minimally invasive treatment
Minimally invasive treatment options are used for infants and toddlers whose blocked tear ducts aren't opening on their own, or for adults who have a partially blocked duct or a partial narrowing of the puncta.

• Dilation, probing and irrigation. This technique works to open congenital blocked tear ducts in most infants. The procedure can be done using general anesthesia or using a restraint in very young babies. First, the doctor enlarges the punctal openings with a special dilation instrument, and then a thin probe is inserted through the puncta and into the tear drainage system. The doctor threads the probe all the way out through the nasal opening, sometimes causing a popping noise as the probe pierces through the extra membrane. The probe is removed, and the tear drainage system is flushed with a saline solution to clear out any remaining blockage.
  For adults with partially narrowed puncta, a similar procedure is done in the doctor's office. The tear ducts are flushed and irrigated while the puncta are dilated. If the problem is related solely to a partial narrowing of the punctal opening, this procedure will often provide temporary relief, at least. Antibiotics may be prescribed for any infections. If irrigation and dilation doesn't work, or if the beneficial effects of the dilation are only temporary, surgery may be necessary to open narrowed puncta. Sometimes, a small incision at the punctal opening may be all that's necessary.
  
• Balloon catheter dilation. This procedure opens tear drainage passages that are narrowed or blocked by scarring, inflammation and other acquired conditions. While you're under general anesthesia, a tube (catheter) with a deflated balloon on the tip is threaded through the lower nasolacrimal duct in your nose. The doctor then uses a pump to inflate and deflate the balloon a few times, sometimes moving it to different locations along the drainage system. This procedure is more effective for infants and toddlers, but also may be used in adults with partial blockage.
• Stenting or intubation. In this procedure, tiny silicone or polyurethane tubes are used to open up blockages and narrowing within the tear drainage system. The procedure, which is usually done under general anesthesia, involves having a thin tube threaded through one or both puncta in the corner of your eye, all the way through the tear drainage system and out through your nose. After the insertion, a small loop of tubing remains visible at the corner of your eye, but it's not usually bothersome. These tubes are generally left in for three to four months, and then removed. Possible complications include inflammation from the presence of the tube.

Surgery
Surgery is usually the treatment of choice for adults and older children with acquired blocked tear ducts. It's also effective in infants and toddlers with congenital blocked tear ducts, though it's typically used after other treatments have been tried.

The surgery used to treat most cases of blocked tear ducts (called dacryocystorhinostomy) reconstructs the passageway for tears to drain out through your nose normally again. First, you're given a general anesthetic, or a local anesthetic if it's performed as an outpatient procedure. The surgeon accesses your tear drainage system, and then creates a new, direct connection between your lacrimal sac and your nose. This new route bypasses the duct that empties into your nose (nasolacrimal duct), which is the most common site of blockage. Stents or intubation typically are placed in the new route while it heals, and then removed three or four months after surgery.
The steps in this procedure vary, depending on the exact location and extent of your blockage, as well as your surgeon's experience and preferences.

• External. An external dacryocystorhinostomy is a commonly used surgical method of opening a blocked tear duct. While you're under general anesthesia, your surgeon makes an incision on the side of your nose, near where the lacrimal sac is located. After connecting the lacrimal sac to your nasal cavity and placing a stent in the new passageway, the surgeon closes up the incision with a few stitches.
• Endoscopic or endonasal. The same bypass procedure can be performed using endoscopic instruments. Instead of making an incision, the surgeon uses a microscopic camera and other tiny instruments inserted through the nasal opening to your duct system. Sometimes, a fiber-optic light is inserted into your puncta to illuminate the surgical area. The benefits of this method are that there's no incision and no scar, and the recovery typically is faster and easier. The drawbacks are that it requires a surgeon with special training, and the success rates aren't as high as with the external procedure.
• Bypassing the entire lacrimal duct system. Depending on the type of blockage, your surgeon may recommend a reconstruction of your entire tear drainage system (called conjunctivodacryocystorhinostomy). Instead of creating a new channel from the lacrimal sac to your nose, the surgeon creates a new route from the inside corner of your eyes (puncta) to your nose, bypassing the tear drainage system altogether.

Following surgery for a blocked tear duct, you'll use a nasal decongestant spray as well as topical eyedrops to prevent infection and reduce postoperative inflammation. After three to six months, you'll return for removal of any stents used to keep the new channel open during the healing process.

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Blind loop syndrome

Blind loop syndrome

Definition:
Blind loop syndrome occurs when part of the small intestine becomes bypassed. The "blind loop" formed by the bypassed intestine means food can't move normally through the digestive tract. The slowly moving food and waste products become a breeding ground for bacteria, which can lead to a condition called bacterial overgrowth. As a result, nutrients may not be fully absorbed. Blind loop syndrome often causes diarrhea and may cause weight loss and malnutrition.

Blind loop syndrome — sometimes called stasis syndrome or stagnant loop syndrome — often occurs as a complication of stomach (abdominal) surgery. But blind loop syndrome can also result from structural problems and some diseases. Sometimes surgery is needed to correct the problem, but antibiotics are the most common treatment.


Symptoms:
Signs and symptoms of blind loop syndrome often include:

• Loss of appetite
• Abdominal pain
• Nausea
• Bloating
• An uncomfortable feeling of fullness after eating
• Diarrhea
• Unintentional weight loss

When to see a doctor
Bloating, nausea and diarrhea are signs and symptoms of many intestinal problems. See your doctor for a full evaluation — especially if you've had abdominal surgery — if you have:

• Persistent diarrhea
• Rapid, unintentional weight loss
• Abdominal pain lasting more than a few days

If you have severe abdominal pain, get immediate medical care.

Causes:
The small intestine is the longest section of your digestive tract, measuring about 20 feet (6.1 meters). The small intestine is where food mixes with digestive juices and nutrients are absorbed into your bloodstream.

Unlike your large intestine (colon), your small intestine normally has relatively few bacteria. But in blind loop syndrome, stagnant food in the bypassed small intestine becomes an ideal breeding ground for bacteria. The bacteria may produce toxins as well as block the absorption of nutrients. The greater the length of small bowel involved in the blind loop, the greater the chance of bacterial overgrowth.

What triggers blind loop syndrome
Blind loop syndrome can be caused by:

• Complications of abdominal surgery, including gastric bypass for extreme obesity and gastrectomy to treat peptic ulcers and stomach cancer
• Structural problems in and around your small intestine, including scar tissue (intestinal adhesions) on the outside of the bowel and small, bulging pouches of tissue that protrude through the intestinal wall (diverticulosis)
• Certain medical conditions, including Crohn's disease, radiation enteritis, scleroderma and diabetes, can slow movement (motility) of food and waste products through the small intestine

Complications:
A blind loop can cause escalating problems, including:

• Poor absorption of fats. Bacteria in your small intestine break down the bile salts needed to digest fats. As a result, your body can't fully absorb the fat-soluble vitamins A, D, E and K. Incomplete absorption of fats leads to diarrhea, weight loss and vitamin deficiency disorders.
• Damage to the intestinal lining. Toxins that are released when bacteria break down stagnant food harm the mucous lining (mucosa) of the small intestine. As a result, most nutrients, including carbohydrates and proteins, are poorly absorbed, leading to serious malnourishment.
• Vitamin B-12 deficiency. Bacteria in the small intestine absorb vitamin B-12, which is essential for the normal functioning of your nervous system and the production of blood cells and DNA. A severe B-12 deficiency can lead to weakness, fatigue, tingling and numbness in your hands and feet, and, in advanced cases, to mental confusion. Damage to your central nervous system resulting from a B-12 deficiency may be irreversible.
• Brittle bones (osteoporosis). Over time, damage to your intestine from abnormal bacterial growth causes poor calcium absorption, and eventually may lead to bone diseases, such as osteoporosis.
• Kidney stones. Poor calcium absorption may also result in kidney stones.

Treatments and drugs:
Whenever possible, doctors treat blind loop syndrome by dealing with the underlying problem — for example, by surgically repairing a postoperative blind loop, stricture or fistula. But the blind loop can't always be reversed. In that case, treatment focuses on correcting nutritional deficiencies and eliminating bacterial overgrowth.

Antibiotic therapy
For most people, the initial way to treat bacterial overgrowth is with antibiotics. Doctors may start this treatment even when test results are inconclusive. A short course of antibiotics often significantly reduces the number of abnormal bacteria. But bacteria can return when the antibiotic is discontinued, so treatment may need to be long term. Some people with a blind loop may go for long periods without needing antibiotics, while others may need them regularly.

Doctors may also switch among different drugs to help prevent bacterial resistance. Antibiotics wipe out most intestinal bacteria, both normal and abnormal. As a result, antibiotics can cause some of the very problems they're trying to cure, including diarrhea. Switching among different drugs can help avoid this problem.

Nutritional support
Correcting nutritional deficiencies is a crucial part of treating blind loop syndrome, particularly in people with severe weight loss. Malnutrition can be treated, but the damage it causes can't always be reversed.

These treatments may improve vitamin deficiencies, reduce intestinal distress and help with weight gain:

• Nutritional supplements. People with blind loop syndrome may need intramuscular injections of vitamin B-12 as well as oral vitamin, calcium and iron supplements.
• Lactose-free diet. Damage to the small intestine may cause you to lose the ability to digest milk sugar (lactose). In that case, it's important to avoid most lactose-containing products, or use lactase preparations that help digest milk sugar. Some people may tolerate yogurt because the bacteria used in the culturing process naturally break down lactose.
• Medium-chain triglycerides. Most dietary fats consist of a long chain of fat molecules (triglycerides). Medium-chain triglycerides, found in coconut oil, are more easily digested by some people with blind loop syndrome. Medium-chain triglycerides are sometimes prescribed as a dietary supplement for people with severe blind loop syndrome resulting in short bowel syndrome.

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Blepharitis

Blepharitis

Definition:
Blepharitis (blef-uh-RI-tis) is inflammation that affects the eyelids. Blepharitis usually involves the part of the eyelid where the eyelashes grow.

Blepharitis commonly occurs when tiny oil glands located near the base of the eyelashes malfunction. This leads to inflamed, irritated and itchy eyelids. Several diseases and conditions can cause blepharitis.
Blepharitis is often a chronic condition that is difficult to treat. Blepharitis can be uncomfortable and may be unattractive,
but it usually doesn't cause permanent damage to your eyesight.


Symptoms:
Blepharitis symptoms and signs include:

• Watery eyes
• Red eyes
• A gritty, burning sensation in the eye
• Eyelids that appear greasy
• Itchy eyelids
• Red, swollen eyelids
• Flaking of the skin around the eyes
• Crusted eyelashes upon awakening
• Eyelid sticking
• More frequent blinking
• Sensitivity to light
• Eyelashes that grow abnormally (misdirected eyelashes)
• Loss of eyelashes

When to see a doctor
If you have blepharitis symptoms and signs that don't seem to be improving despite good hygiene — regular cleaning and care of the affected area — make an appointment with your doctor.


Causes:
The exact cause of blepharitis isn't clear. Factors associated with the development of blepharitis include:

• Seborrheic dermatitis — dandruff of the scalp and eyebrows
• A bacterial infection
• Malfunctioning oil glands in your eyelid
• Rosacea — a skin condition characterized by facial redness
• Allergies, including allergic reactions to eye medications, contact lens solutions or eye makeup
• Eyelash mites or lice
• Certain medication — the severe acne medication isotretinoin (Amnesteem, Claravis, Sotret) can lead to an increase in bacteria on the eyelids and can affect tear production

Blepharitis may be caused by a combination of factors.


Complications:
 If you have blepharitis, you may also experience:

• Eyelash problems. Blepharitis can cause your eyelashes to fall out or grow abnormally (misdirected eyelashes).
• Eyelid skin problems. Scarring may occur on your eyelids in response to long-term blepharitis.
• Excess tearing or dry eyes. Abnormal oily secretions and other debris shed from the eyelid, such as flaking associated with dandruff, can accumulate in your tear film — the water, oil and mucus solution that forms tears. Abnormal tear film interferes with the healthy lubrication of your eyelids. This can irritate your eyes and cause dry eyes or excessive tearing.
• Difficulty wearing contact lenses. Because blepharitis can affect the amount of lubrication in your eyes, wearing contact lenses may be uncomfortable.
• Sty. A sty is an infection that develops near the base of the eyelashes. The result is a painful lump on the edge (usually on the outside part) of your eyelid. A sty is usually most visible on the surface of the eyelid.
• Chalazion. A chalazion occurs when there's a blockage in one of the small oil glands at the margin of the eyelid, just behind the eyelashes. The gland can become infected with bacteria, which causes a red, swollen eyelid. Unlike a sty, a chalazion tends to be most prominent on the inside of the eyelid.
• Chronic pink eye. Blepharitis can lead to recurrent bouts of pink eye (conjunctivitis).
• Injury to the cornea. Constant irritation from inflamed eyelids or misdirected eyelashes may cause a sore (ulcer) to develop on your cornea. Insufficient tearing could predispose you to a corneal infection

Treatments and drugs:
Treatment for blepharitis can include:

• Cleaning the affected area regularly. Cleaning your eyelids with a warm washcloth can help control signs and symptoms. Self-care measures may be the only treatment necessary for most cases of blepharitis.
• Antibiotics. Eyedrops containing antibiotics applied to your eyelids may help control blepharitis caused by a bacterial infection. In certain cases, antibiotics are administered in cream, ointment or pill form.
• Steroid eyedrops or ointments. Eyedrops or ointments containing steroids can help control inflammation in your eyes and your eyelids.
• Artificial tears. Lubricating eyedrops or artificial tears, which are available over-the-counter, may help relieve dry eyes.
• Treating underlying conditions. Blepharitis caused by seborrheic dermatitis, rosacea or other diseases may be controlled by treating the underlying disease.

Blepharitis rarely disappears completely. Even with successful treatment, relapses are common.

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Blastocystis hominis infection

Blastocystis hominis infection

Definition:

Blastocystis hominis (B. hominis) is a microscopic parasite sometimes found in the stools of healthy people as well as in the stools of those who have diarrhea, abdominal pain or other gastrointestinal problems. Infection with B. hominis is called blastocystosis.

Researchers don't yet fully understand the role that B. hominis plays in causing an infection. Certain subtypes of this parasite may be more likely to cause infection, or may pose a risk only when combined with other types of infection. In some cases, the parasite simply resides in the digestive tract without causing harm.

There are no proven treatments for Blastocystis, and the infection usually clears up on its own. However, if signs and symptoms don't improve, your doctor may recommend trying medications.


Symptoms:

Signs and symptoms that might be associated with blastocystis include:

• Diarrhea
• Nausea
• Abdominal cramps
• Bloating
• Excessive gas (flatulence)
• Anal itching
• Fatigue

When to see a doctor
See your doctor if you have signs and symptoms associated with blastocystis, such as diarrhea, cramps and fatigue that last longer than three days.


Causes:

Once thought to be a harmless yeast, B. hominis is a parasite, a microscopic single-celled organism (protozoan). It behaves like a tiny animal — hunting and gathering other microbes for food. Many protozoa inhabit your gastrointestinal tract and are harmless; others cause disease.

Whether B. hominis is the type of protozoa that causes disease is controversial. While many people who carry B. hominis have no signs or symptoms, others have diarrhea and other gastrointestinal problems. Because B. hominis often appears with other organisms, experts aren't sure whether B. hominis causes disease on its own.

It's possible that some people are susceptible to illness caused by B. hominis infection, while others carry the parasite without signs or symptoms.

Many types of protozoa get into the intestinal tract through oral-fecal contact, such as occurs when a person doesn't wash his or her hands thoroughly after using the toilet before preparing food. No one knows for certain how B. hominis is transmitted, but experts suspect it's through oral-fecal contact. Experts do know that the incidence of infection associated with B. hominis increases in places with inadequate sanitation and poor personal hygiene.

Complications:

 If you have diarrhea associated with B. hominis, it's likely to be self-limiting. However, anytime you have diarrhea, you lose vital fluids, salts and minerals, which can lead to dehydration. Children are especially vulnerable to dehydration.


Treatments and drugs:

If you have blastocystis without signs or symptoms, then you don't need treatment. Mild signs and symptoms may improve on their own within a few days.

Potential medications for treating blastocystis include the antibiotic metronidazole (Flagyl), the combination medication sulfamethoxazole and trimethoprim (Bactrim, Septra, others), and the antiprotozoal medication iodoquinol (Yodoxin, others). However, keep in mind that response to medication for B. hominis infection varies greatly from person to person. And, because the symptoms you're having might be unrelated to blastocystis, it's also possible that any improvement may be due to the medication's effect on another organism.

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Bladder cancer

Bladder cancer

Definition:

Bladder cancer is a type of cancer that begins in your bladder — a balloon-shaped organ in your pelvic area that stores urine. Bladder cancer begins most often in the cells that line the inside of the bladder. Bladder cancer typically affects older adults, though it can occur at any age.

The great majority of bladder cancers are diagnosed at an early stage — when bladder cancer is highly treatable. However, even early-stage bladder cancer is likely to recur. For this reason, bladder cancer survivors often undergo follow-up tests to look for bladder cancer recurrence for years after treatment.


Symptoms:

Bladder cancer signs and symptoms may include:

• Blood in urine (hematuria) — urine may appear dark yellow, bright red or cola colored. Or urine may appear normal, but blood may be detected in a microscopic examination of the urine
• Frequent urination
• Painful urination
• Back pain
• Pelvic pain

When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms that worry you, such as blood in your urine.

Causes:

It's not always clear what causes bladder cancer. Bladder cancer has been linked to smoking, a parasitic infection, radiation and chemical exposure.

Bladder cancer develops when cells in the bladder begin to grow abnormally. Rather than grow and divide in an orderly way, these cells develop mutations that cause them to grow out of control and not die. These abnormal cells form a tumor.

Types of bladder cancer
Different types of cells in your bladder can become cancerous. The type of bladder cell where cancer begins determines the type of bladder cancer. Your bladder cancer type determines which treatments may work best for you. Types of bladder cancer include:

• Transitional cell carcinoma. Transitional cell carcinoma occurs in the cells that line the inside of your bladder. Transitional cells expand when your bladder is full and contract when your bladder is empty. These same cells line the inside of your ureters and your urethra, and tumors can form in those places as well. Transitional cell carcinoma is the most common type of bladder cancer in the United States.
• Squamous cell carcinoma. Squamous cells appear in your bladder in response to infection and irritation. Over time they can become cancerous. Squamous cell bladder cancer is rare in the United States. It's more common in parts of the world where a certain parasitic infection (schistosomiasis) is a prevalent cause of bladder infections.
• Adenocarcinoma. Adenocarcinoma begins in cells that make up mucus-secreting glands in the bladder. Adenocarcinoma of the bladder is rare in the United States.

Some bladder cancers include more than one type of cell.


Complications:

Bladder cancer often recurs. Because of this, bladder cancer survivors often undergo follow-up testing for years after successful treatment. What tests you'll undergo and how often will depend on your type of bladder cancer and your treatment, among other factors.

Ask your doctor to create a follow-up plan for you. In general, doctors recommend a test to examine the inside of your urethra and bladder (cystoscopy) every three to six months for the first few years after bladder cancer treatment. Then you may undergo cystoscopy every year. Your doctor may recommend other tests at various intervals as well.

People with aggressive cancers may undergo more frequent screening. Those with less aggressive cancers may undergo screening tests less often.


Treatments and drugs:

Your treatment options for bladder cancer depend on a number of factors, including the type and stage of the cancer, your overall health, and your treatment preferences. Discuss your options with your doctor to determine what treatments are best for you.

Surgical procedures
The types of surgical procedures available to you may be based on factors such as the stage of your bladder cancer, your overall health and your preferences.

Surgery for early-stage bladder cancer
If your cancer is very small and hasn't invaded the wall of your bladder, your doctor may recommend:

• Surgery to remove the tumor. Transurethral resection (TUR) is often used to remove bladder cancers that are confined to the inner layers of the bladder. During TUR, your doctor passes a small wire loop through a cystoscope and into your bladder. The loop is used to burn away cancer cells with an electric current. In some cases, a high-energy laser may be used instead of electric current. TUR may cause painful or bloody urination for a few days following the procedure.
  
• Surgery to remove the tumor and a small portion of the bladder. During segmental cystectomy, sometimes called partial cystectomy, the surgeon removes only the portion of the bladder that contains cancer cells. Segmental cystectomy may be an option if your cancer is limited to one area of the bladder that can easily be removed without harming bladder function.
  Surgery carries a risk of bleeding and infection. You may experience more frequent urination after segmental cystectomy, since the operation reduces the size of your bladder. Over time, this may improve.
  

Surgery for invasive bladder cancer
If your cancer has invaded the deeper layers of the bladder wall, you may consider:

• Surgery to remove the entire bladder. A radical cystectomy is an operation to remove the entire bladder, as well as surrounding lymph nodes. In men, radical cystectomy typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy involves removal of the uterus, ovaries and part of the vagina.
  
  Cystectomy carries a risk of infection and bleeding. In men, removal of the prostate and seminal vesicles may cause erectile dysfunction. But in many cases, your surgeon can attempt to spare the nerves necessary for an erection. In women, removal of the ovaries causes infertility and premature menopause.
  
  
• Surgery to create a new way for urine to leave your body. Immediately after your radical cystectomy, your surgeon works to create a new way for you to expel urine. Several options exist. Which option is best for you depends on your situation and your preferences. Your surgeon may create a tube (urinary conduit) using a piece of your intestine. The tube runs from your kidneys to the outside of your body, where your urine drains into a pouch (urostomy bag) you wear on your abdomen.
  
  In another procedure, your surgeon may use a section of intestine to create a small reservoir for urine inside your body (cutaneous continent urinary diversion). You can drain urine from the reservoir through a hole in your abdomen using a catheter a few times each day.
  
  In select cases, your surgeon may create a bladder-like reservoir out of a piece of your intestine (neobladder). This reservoir sits inside your body and is attached to your urethra, which allows you to urinate normally. You may need to use a catheter to drain all the urine from your neobladder.
  

Biological therapy (immunotherapy)
Biological therapy, sometimes called immunotherapy, works by signaling your body's immune system to help fight cancer cells. Biological therapy for bladder cancer is typically administered through your urethra and directly into the bladder (intravesical therapy).
Biological therapy drugs used to treat bladder cancer include:

• An immune-stimulating bacterium. Bacille Calmette-Guerin (BCG) is a bacterium used in tuberculosis vaccines. BCG can cause bladder irritation and blood in your urine. Some people feel as if they have the flu after treatment with BCG.
  
• A synthetic version of an immune system protein. Interferon is a protein that your immune system makes to help your body fight infections. A synthetic version of interferon, called interferon alfa-2b (Intron A), may be used to treat bladder cancer. Interferon alfa-2b is sometimes used in combination with BCG. Interferon alfa-2b can cause flu-like symptoms.

Biological therapy can be administered after TUR to reduce the risk that cancer will recur.

Chemotherapy
Chemotherapy uses drugs to kill cancer cells. Chemotherapy treatment for bladder cancer usually involves two or more chemotherapy drugs used in combination. Drugs can be given through a vein in your arm (intravenously), or they can be administered directly to your bladder by passing a tube through your urethra (intravesical therapy).

Chemotherapy may be used to kill cancer cells that might remain after surgery. It may also be used before surgery. In this case, chemotherapy may shrink a tumor enough to allow the surgeon to perform a less invasive surgery. Chemotherapy is sometimes combined with radiation therapy.

Radiation therapy
Radiation therapy is used infrequently in people with bladder cancer. Radiation therapy uses high-energy beams aimed at your cancer to destroy the cancer cells. Radiation therapy for bladder cancer usually comes from a machine that moves around your body, directing the energy beams to precise points.

Radiation therapy can be used after surgery to kill cancer cells that might remain. Radiation therapy is sometimes combined with chemotherapy.

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Bladder stones

Bladder stones

Definition:

Bladder stones are usually small masses of minerals that form in your bladder. Bladder stones develop when urine in your bladder becomes concentrated, causing minerals in your urine to crystallize. Concentrated, stagnant urine is often the result of not being able to completely empty your bladder. This may be due to an enlarged prostate, nerve damage or recurring urinary tract infections.

Bladder stones don't always cause signs or symptoms and may be discovered during tests for other problems. When symptoms do occur, they can range from abdominal pain to blood in your urine.
Small bladder stones sometimes pass on their own, but you may need to have others removed by your doctor. Left untreated, bladder stones can cause infections and other complications.

Symptoms:

Some people with bladder stones have no problems — even when their stones are large. But if a stone irritates the bladder wall or blocks the flow of urine, signs and symptoms can develop. These include:

• Lower abdominal pain
• In men, pain or discomfort in the penis
• Painful urination
• Frequent urination, especially during the night
• Difficulty urinating or interruption of urine flow
• Blood in your urine
• Cloudy or abnormally dark-colored urine

Causes:

Bladder stones generally begin when your bladder doesn't empty completely. The urine that's left in your bladder can form crystals that eventually become bladder stones. In most cases, an underlying condition affects your bladder's ability to empty completely.
The most common conditions that cause bladder stones include:

• Prostate gland enlargement. An enlarged prostate, or benign prostatic hyperplasia (BPH), can be a cause of bladder stones in men. As the prostate enlarges, it can compress the urethra and interrupt urine flow, causing urine to remain in your bladder.
  
• Damaged nerves (neurogenic bladder). Normally, nerves carry messages from your brain to your bladder muscles, directing your bladder muscles to tighten or release. If these nerves are damaged — from a stroke, spinal cord injury or other health problem — your bladder may not empty completely.
  
• Weakened bladder wall. Bladder diverticula are weakened areas in the bladder wall that bulge outward in pouches, and allow urine to collect.

Other conditions that can cause bladder stones include:

• Inflammation. Bladder stones can develop if your bladder becomes inflamed. Urinary tract infections and radiation therapy to your pelvic area can both cause bladder inflammation.
  
• Medical devices. Occasionally, catheters — slender tubes inserted through the urethra to help urine drain from your bladder — can cause bladder stones. So can objects that accidentally migrate to your bladder, such as a contraceptive device or stent. Mineral crystals, which later become stones, tend to form on the surface of these devices.
  
• Kidney stones. Stones that form in your kidneys are not the same as bladder stones. They develop in different ways and often for different reasons. But small kidney stones occasionally travel down the ureters into your bladder and if not expelled, can grow into bladder stones.

Complications:

Bladder stones that aren't removed — even those that don't cause symptoms — can lead to complications, such as:

• Chronic bladder dysfunction. Left untreated, bladder stones can cause long-term urinary problems, such as pain or frequent urination. Bladder stones can also lodge in the opening where urine exits the bladder into the urethra and block the passage of urine from your body.
• Urinary tract infections. Recurring bacterial infections in your urinary tract may be caused by bladder stones. 

Treatments and drugs:

Generally, bladder stones should be removed. If the stone is small, your doctor may recommend that you drink an increased amount of water each day to help the stone pass. However, because bladder stones are usually caused by the inability to empty the bladder completely, spontaneous passage of the stones is unlikely. Almost all cases require removal of the stones.

Breaking stones apart
Bladder stones are often removed during a procedure called a cystolitholapaxy. A small tube with a camera at the end (cystoscope) is inserted through your urethra and into your bladder to view the stone. Your doctor then uses a laser, ultrasound or mechanical device to break the stone into small pieces and flushes the pieces from your bladder.

You'll likely have regional or general anesthesia prior to the procedure to make you comfortable. Complications from a cystolitholapaxy aren't common, but urinary tract infections, fever, a tear in your bladder and bleeding can occur. Your doctor may give you antibiotics before the procedure to reduce the risk of infections. About a month after the cystolitholapaxy, your doctor will likely check to make sure that no stone fragments remain in your bladder.

Surgical removal
Occasionally, bladder stones that are large or too hard to break up are removed through open surgery. In these cases, your doctor makes an incision in your bladder and directly removes the stones. Any underlying condition causing the stones, such as an enlarged prostate, may be corrected at the same time.

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Black, hairy tongue

Black, hairy tongue

Definition:

Black, hairy tongue is a temporary, harmless (benign), painless oral condition that gives your tongue a dark, furry appearance. The distinct look of black, hairy tongue usually results from an overgrowth of bacteria in the mouth.

Although black, hairy tongue may look alarming, it doesn't cause any health problems. Black, hairy tongue usually resolves without medical treatment.

Symptoms:

Signs and symptoms of black, hairy tongue include:

• Black, yellow or brown discoloration of the tongue
• A hairy or furry appearance of the tongue
• Altered taste or metallic taste in mouth
• Bad breath (halitosis)
• Gagging sensation in some people

When to see a doctor
Though unattractive, black, hairy tongue is usually a temporary, harmless condition. See your doctor if:

• You're concerned about the appearance of your tongue
• Your signs and symptoms persist for more than 10 days

Causes:

Black, hairy tongue typically results when projections on the tongue called papillae grow longer (elongate) and don't shed like normal. This makes the tongue look hairy. Debris, bacteria or other organisms can collect on the papillae and result in black, yellow or brown discoloration.
The cause of black, hairy tongue can't always be determined. However, potential causes include:

• Changes in the normal bacteria or yeast content of the mouth following antibiotic use
• Poor oral hygiene
• Breathing through your mouth
• Medications containing bismuth, such as Pepto-Bismol
• Regular use of mouthwashes containing oxidizing agents, such as peroxide, or astringent agents, such as witch hazel or menthol
• Heavy tobacco use

Treatments and drugs:

Black, hairy tongue typically doesn't require medical treatment. Though unattractive, it's a temporary, harmless condition.

Practicing good oral hygiene and eliminating factors that potentially contribute to the condition — such as tobacco use or medications that contain bismuth — help resolve black, hairy tongue. Talk to your doctor or dentist before discontinuing a prescribed medication.

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