What is Lupus?

Lupus

Lupus is an autoimmune disease which causes long term inflammation in many parts of the body, including the skin, joints, kidneys, blood cells, heart and lungs. The disease is characterized by episodes of wellness and illness. Periods of illness are called 'flares'.

Lupus usually appears in one of two forms - systemic lupus erythematosus (SLE) or discoid lupus erythematosus (DLE). SLE is the most common form of lupus, and it can can affect several parts of the body, while DLE involves inflammation of the skin only.

What causes lupus?

In an autoimmune disease, the immune system attacks the person's own body, leading to inflammation. While the exact cause is unknown, a combination of hereditary, environmental and hormonal factors may play a part in triggering the illness. Other triggers include bacteria and viruses.

Who are at risk?

Women are 9 times more likely to get it than men. It is also more common in Asian, Black and Hispanic races. Having a close relative with lupus seems to increase your chances as well. It can show up for the first time during pregnancy or shortly after birth, and women with lupus can have flares around this time.

What are the signs and symptoms?

Lupus can be mild or severe, and there are times when there are no symptoms at all. Common signs and symptoms include:

• Butterfly-shaped rash over the nose and cheeks, neck or chest. 
• Skin becomes more sensitive to the sun.
• Mouth ulcers
• Joint pains affecting the knees, wrists, hands and fingers.
• Kidney problems (may lead to high blood pressure and ankle swelling).
• Others: headaches, seizures, dizziness, eye problems and behavioral changes.
• During flares, people feel very tired and may have a fever.

How is it diagnosed?

Usually diagnosed through medical history and physical examination, and presence of defining symptoms. However, the diagnosis can be difficult, as the disease varies from person to person, fluctuates with time, and affects many different parts of the body. Therefore it may not be diagnosed until the symptoms become more obvious. To help confirm the diagnosis, blood tests including a test for antinuclear antibody (ANA), may be done. If the ANA test is positive, it means that the immune system is being stimulated, which ties in with lupus.

What are the treatments?

The objective of treatment is to ease the symptoms and reduce long term complications. It also depends on which part of it is affected. Medications include non-steroidal anti-inflammatory drugs (e.g. ibuprofen), steroids and drugs to suppress the immune system. Anti-malarial drugs appear to be effective for the rashes, joint pain and internal inflammation. Patients may also be advised to rest, exercise, and avoid sun exposure.

What is Genital Herpes?

Genital herpes

It is a sexually transmitted infection that can't be cured.

What causes genital herpes?

It is caused by the herpes simplex virus. The Type 1 virus typically gives cold sores on the lips, while the Type 2 virus affects the genitals. With the increasing practice of oral sex, Type 1 is now also a common cause of genital herpes.

Who are at risk?

Anyone who has ever had sex (especially with someone who has it) is at risk. It can be spread through vaginal, anal, or oral sex, and also by touching the infected area of the person who has it.

What are the signs and symptoms?

The disease can range from being totally without symptoms, and therefore unknown to the person carrying it, to mild itchy, tender red spots on the genitals, to excruciating blisters and sores of the genirals with fever and general unwellness. Other symptoms may include:

• Headache
• Shooting pains in the back and legs
• Swollen groin glands
• Difficulty passing urine

After the first attack, which may last up to 3 weeks, recurrences may occur, of which are often milder and shorter-lived. The recurrences may be frequent (e.g. monthly) or rare.

What are the complications?

• You can spread it to others.
• You have a higher risk for HIV infection.
• If you are pregnant, your baby could get infected while being born.

How is it diagnosed?

A doctor specializing in the skin or in sexual infections will often make a diagnosis based on the patient's history and on examination. Swabs can be sent to the lab, which may be helpful in trying to confirming the diagnosis.

What are the treatments?

The goal of treatment for genital herpes is to provide relief from herpes sores and to shorten the time for the outbreak to heal. Treatment works best if it is started as soon as possible after the start of an outbreak.

Anti-viral drugs, such as aciclovir, famciclovir and valacyclovir, are recommended to treat first genital herpes outbreak. Most people find relief and recover more quickly (e.g. heal the sores) from the first attack by taking antiviral medicines. Antiviral medicines also helps prevent further outbreaks and reduces the risk of people passing the virus to their sex partner(s).

To reduce pain and fever from genital herpes, one may use non-prescription drugs such as ibuprofen or acetaminophencan.

Patients may need some counseling to come to terms with the infection, and to learn how to prevent transmission to sexual partners.

What is Inflammatory Bowel Disease (IBD)?

Inflammatory bowel disease (IBD)

IBD encompasses two separate conditions - ulcerative colitis and Crohn's disease. In both conditions, there is inflammation in the lining of the digestive tract, specifically the large intestines in ulcerative colitis, and mostly the small intestines in Crohn's. The inflammation causes swelling, redness, ulceration and bleeding.

What causes IBD?

Exact cause is not clear yet, but genetic factor plays a role. About 15-30% of people with IBD have a family member who also has the same problem. There are many changes in the immune system in IBD sufferers which are not fully understood.

Who are at risk?

IBD can affect any age, from young children to the elderly, but often affects young adults in their late teens or 20s. Women and men are equally affected.

What are the signs and symptoms?

Common signs and symptoms:

• Abdominal pain and cramping
• Bloating/distension
• Blood in the stool
• Loss of appetite
• Mucus in the stool
• Persistent diarrhea
• Ulceration in the digestive tract

What are the complications?

Poor nutrition, weight loss and anemia may result.

Crohn's disease can cause inflammation anywhere in the digestive tract from the mouth to the anus, and can lead to tunnels, called fistulas, forming between the bowel and the skin or surrounding structures such as the bladder. These can get infected and become abscesses.

Ulcerative can lead to joint, eye, liver and skin problems, although it is not clear why. There is an increased risk of bowel cancer.

How is it diagnosed?

Apart from medical examination, stool samples and blood tests may be necessary. The bowels may also be investigated with colonoscopy (a flexible scope is put through the anus to visualize the lining of the bowels) or X-ray techniques.

What are the treatments?

Treatment for IBD is highly individualized depending on the type and severity of the symptoms. It is aimed at improving the nutrition of the sufferer and keeping them as well as possible. Treatment options for IBD include dietary changes, medications and sometimes surgery.

Drugs include mesalamine agents, antibiotics, corticosteroids, azathioprine and infliximab. Surgery is reserved for people who are very unwell, for whom drug options have failed, and to relieve emergencies such as bowel obstruction. Surgery may result in a temporary or permanent 'stoma', or opening of the bowel onto the abdomen. A bag has to be placed over this opening to collect waste material.

What is Migraine?

Migraine

It is more than just a bad headache. In fact, it is a debilitating condition that causes severe headache, visual disturbances and sometimes nausea and vomiting.

What causes it?

The exact cause of migraine is not fully understood, but it is believed to be related to changes in the trigeminal nerve system (a major pain pathway in the brain) and an imbalance of brain chemical, such as serotonin. Triggers include:

• Hormones - women tend to suffer more around the time of their menstruation, or during pregnancy
• Food, such as alcohol, cheese and chocolate
• Stress
• Insufficient or too much sleep

Who are at risk?

Women are three times more likely to suffer from migraine than men. 80% of people with migraine have a family member who is also affected. If one parent has migraine, their children have a 50% chance of having it too.

What are the signs and symptoms?

• Severe headache - throbbing or pulsating - may affect one or both sides of the head
• Headache gets worse with any active movement
• There may be nausea and vomiting
• Sufferer becomes very sensitive to light or sound
• Symptoms can last from several hours to several days, and varies in frequency
• Sufferers may get an 'aura' just before an attack, such as seeing flashing lights, zigzag lines or a spreading blind spot in their vision
• May also experience tingling or weakness in one arm or leg and speech problems
• May feel more energetic or elated, or become depressed, or have food cravings in the hours or days before an attack

How is it diagnosed?

Migraine can usually be diagnosed by the patient's list of symptoms and a medical examination. If further tests such as brain scans are needed, they are often to exclude other causes of headache.

What are the treatments?

For pain relief, strong painkillers such as ibuprofen can be useful. If these are not good enough, a group of drugs called triptans, designed specifically for migraine, work very well. Medicine may also be necessary for nausea. It is not fully understood, but some heart medicines seem to be able to prevent migraine. These include beta-blockers and calcium channel blockers. Anti-depressants and anti-epilepsy drugs are also useful.