Category Archives: Irritable Bowel Syndrome
Skin Rashes in Infants
Skin rashes of different types may occur in infants and children due to various reasons, but usually they are not very serious.
- Rashes in infants may be caused by viral, fungal and bacterial infections, or due to irritation of the skin and allergies.
- Different types of rashes include itchy red rashes; fluid filled cysts; yellow scaly rashes; milky pimples or bumps on the skin.
- Many rashes disappear without any treatment. Some may become better with the application of moisturizers and gentle cleansing lotions.
- Application of anti fungal and anti bacterial ointments and antibiotic therapy may be necessary in some cases. Anti-itch medication can relieve severe itching.
Diaper rash:
It is one of the most common rashes in infants. This bright red rash appearing in the diaper area is due to the irritation caused to the tender skin by the almost constant contact with excretory materials such as urine and stools. The areas of the skin which are in touch with the diaper are especially affected. It is also referred to as diaper dermatitis.
Bacterial and fungal infections can also cause diaper rash. A typical fungal infection caused by Candida gives rashes, bright red in color, along the skin creases. Tiny red spots also may be present. Diaper rash due to bacterial infections are rarer. Babies who are exclusively fed on breast milk are found to have lower incidence of diaper rash as their stools may not have as many irritating substances and enzymes as the stools of infants who take formula milk. Using highly absorbent diapers, with moisture-locking gel filling, may reduce rashes by keeping the infant dry. Frequent diaper changes, and avoiding plastic pants which keep moisture in and restrict air circulation, also may help. Most children who have diaper rash are not usually bothered by the condition.
The usual treatment for diaper dermatitis is frequent change of diapers, and allowing for air circulation in the diaper area. Mild soaps should be used to clean the affected area. Most cases of diaper rash clear up without any further treatment. Petroleum jelly, ointments containing zinc, vitamin A & D ointment, or moisturizers, can act as a barrier to moisture and may prevent rashes. If Candida infection is present, the doctor may prescribe an antifungal cream to clear up the rash. Antibiotic creams may be required to treat rashes caused due to bacterial infections.
Eczema:
It is a dry rash causing the skin in the affected area to appear red and scaly. It usually appears as patches at the joints of the hands and legs. Cold weather and dry climate worsens the condition. The rashes due to eczema, otherwise referred to as atopic dermatitis, may come and go without any apparent reason. Its cause is also not known. Allergy is thought to be the trigger for eczema and it is considered to be similar in origin to asthma. It usually runs in families too, much like asthma does.
Many children who have eczema in infancy and childhood may outgrow the condition eventually. However, in some cases, the episodes continue lifelong. There is no cure for eczema, but the condition can be treated with moisturizers, corticosteroid creams and the use of gentle cleansing agents. Anti-itch medication, and humidified air, may give some relief to the itching and scaling skin. Identifying triggers such as dust mites and other allergens, and avoiding them, may reduce the frequency and severity of attacks.
Cradle cap:
It is a crusty and scaling yellow and red rash often occurring on the infant’s scalp. Occasionally it may appear in some skin folds too. The cause of this condition, also referred to as seborrheic dermatitis, is not known. Infants with cradle cap do not seem to be bothered by the condition, and it usually disappears by the time the infant is six months old. Applying mineral oil to the scalp, and using shampoos regularly to wash the head, may help reduce the crusty scales. Those crusts tangled in the hair can be gently removed with a comb. A severe cradle cap which persists, and does not respond to the above measures, may require treatment with corticosteroid creams or the application of shampoos containing selenium.
Tinea:
It is a fungal infection affecting the skin in different parts of the body. While tinea capitis affects the skin of the scalp, tinea corporis, commonly called ringworm, appears on the body. When tinea is diagnosed in infants and children, it is treated in the same way this fungal infection is treated in adults. In some children, the condition may be worsened by an inflammatory response to the infection causing the formation of a scalp mass known as kerion. This complication requires further specialized treatment.
Molluscum contagiosum:
It is a rash caused by a virus. It appears as a cluster of pearly pimples or flesh-colored bumps, and disappears after a while without any specific treatment.
Milia:
They appear as small pearly white cysts on the infant’s face in the early days of life. It is caused by the first oil secretions from the newborn’s skin glands. They disappear within days, without any treatment.
Common Viral Infections:
They are common causes of rashes appearing suddenly in infants, as well as, children. Roseola, rubella, and the infection erythema infectiosum, which is known as the fifth disease, are viral infections causing characteristic rashes. They are not serious, and do not cause much discomfort to the children. Other common rash-forming viral diseases such as chicken pox and measles are increasingly becoming rare as vaccinations against them are being widely used.
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What Is IBS (Irritable Bowel Syndrome)
What is IBS ?Irritable bowel syndrome is a functional disorder affecting the digestive system, characterized by abdominal cramping and pain often accompanied by variations in the bowel movements such as diarrhea or constipation.
- Abdominal cramping and pain, gas and bloating are the usual symptoms. Either constipation or diarrhea may be present.
- Symptoms of irritable bowel syndrome are triggered by various factors such as emotional stress and anxiety, as well as certain food items
- Typical symptoms of IBS may be sufficient for diagnosis, but further investigations are done to eliminate other possible causes with similar symptoms.
- Symptoms can be treated with appropriate drugs; regularity in dietary habits may help avoid the development of symptoms.
Irritable bowel syndrome or IBS is a functional disorder and is different from inflammatory conditions such as Crohn’s disease. There are no structural changes or abnormalities associated with this condition; the intestines look normal in imaging tests like x-rays and when viewed with endoscope. The symptoms are caused by certain abnormalities in the movement of the intestines and the workings of the nerves associated with the digestive system.
IBS is a very common condition occurring in about ten to fifteen percent of people irrespective of gender, but some studies have shown that women having the symptoms approach the doctor more frequently than men. Among the digestive disorders brought to the attention of gastroenterologists, IBS is usually the most probable condition diagnosed. Since the structural abnormalities usually associated with the different disorders of the digestive system are absent in the case of IBS, it is mainly diagnosed by the symptoms alone. There are no specific tests to identify the condition; tests only help to confirm the diagnosis by eliminating the possibility of other diseases.
Causes
The exact reason for the occurrence of IBS is unknown but an oversensitivity of the digestive system to various stimuli is regarded to be causing the symptoms. People who have IBS are affected by contractions of the gastro intestinal muscles and gas in the digestive tract more than other people, who generally feel no great discomfort from such frequent occurrences during the digestive process. Abnormal intestinal movements are considered to be the reason for alterations in the bowel movements such as diarrhea and constipation associated with IBS, but it is not necessarily so in all cases. Abnormal contractions are not present in all those who have IBS and even when they are present, the symptoms do not always occur at the same time.
Minor irritants, both emotional and physical stress, and changes in the diet, both in quantity and timings, are known to bring about episodes of symptoms or worsen existing symptoms. Emotional stress, depression, fear and anxiety often act as triggers. Heavy meals, diet rich in fats, consumption of tea or coffee, dairy products, wheat and citrus fruits are just a few of the dietary factors known to cause flare ups. Eating meals hurriedly, and going without food for longer than usual periods of time, also aggravate the condition. Since the reactions to certain foods are not always consistent, it is difficult identify and avoid irritants. It is not always a specific food allergy which causes symptoms but at different times, different substances precipitate adverse reactions. The reason for inconsistencies in the body’s reaction to the same agents is still not understood.
Symptoms
Symptoms of IBS usually start appearing in the teenagers and people in the early twenties. The symptoms appear without any warning and often disappear without any medication. The episodes recur frequently and unpredictably but they usually occur only when he person is conscious and awake. They rarely disturb sleep. IBS can start developing later in life too, but it is much less common than the early onset of the disease.
The most common symptom of IBS is abdominal cramping and pain which almost always gets relieved when the person has a bowel movement. The frequency of bowel movements and the consistency of stool keep changing. Distention or bloating of the abdomen and feeling of fullness in the rectum even after a bowel movement are some of the features of this condition. The stool may contain mucus too. Pain in the lower abdomen may be sharp and intermittent like cramps or it may be a dull constant ache lasting over a period of time. Nausea, gas, headache, depression general fatigue and anxiety are other symptoms usually found along with pain and bloating of the abdomen. The severity and duration of symptoms may change from time to time but some pattern may emerge with regard to the triggers that precipitate the symptoms and changes in the bowel movements.
Diagnosis
There may not be any outward symptoms in a person which indicate the presence of IBS. The doctor may not detect any abnormalities during a physical examination too, except for a slight tenderness felt when pressing the area above the large intestine. Several tests are done including stool tests, blood tests and viewing test such as colonoscopy or sigmoidoscopy. These tests are not for detecting IBS but to ensure that the person is not having other inflammatory diseases such as ulcerative colitis, Crohn’s disease, lymphocytic or collagenous colitis etc., which have symptoms similar to those of IBS. Colon cancer is another disease to be ruled out. If the person is having IBS and no other disorder, the test results will be normal. However, invasive tests like sigmoidoscopy usually result in the worsening of the symptoms in people who have IBS.
In people 40 years and older, the risk of inflammatory diseases and cancer are higher; hence more tests, including abdominal scans, x-rays, and colonoscopy, are conducted. If certain other symptoms such as bloody stools or bleeding from the rectum, fever, and vomiting or weight loss are also present, in addition to the typical symptoms of IBS, detailed testing is necessary. In a person diagnosed with IBS, other digestive disorders such as gastric ulcers, appendicitis, cancer or gall bladder disease may develop eventually as the person gets older. The additional symptoms precipitated by the new developments should be taken seriously and investigations should be conducted. Any change in the pattern or severity of existing symptoms also should be brought to the attention of the doctor.
What Is IBS Treatment
Treatment depends on the symptoms and the conditions which trigger flare ups in different people. If the triggers are identified, they can be avoided as much as possible. If emotional stress is aggravating the disease, people should learn ways to avoid such stressful situations or learn techniques to handle stress such as yoga, meditation, breathing exercises etc. Constipation can be avoided by physical activity on a regular basis, in addition to following a fiber-rich diet.
A simple diet with regularity in mealtimes is ideal for managing irritable bowel syndrome. Several smaller meals evenly distributed throughout the day may be better than having two or three heavy meals. Cabbage, beans, and other food items which are hard to digest, and are known to produce gas, should be avoided by people who have complaints such as abdominal bloating and flatulence. Certain food additives like sorbitol, which is used as a sweetening agent in dietetic food items and chewing gums as well as in certain drugs, should be avoided as much as possible. Fruit sugar known as fructose, abundant in berries and as a food additive in some sweets, should be consumed in small quantities only. A diet low in fat content is found to be beneficial for some people who have frequent motions. If a person is lactase deficient in addition to having irritable bowel syndrome, lactose rich food items, mainly milk and milk products, should be avoided or taken in small quantities.
A diet rich in fiber content is usually sufficient to tackle constipation, but addition of bran to the diet or taking spsyllium preparations help in keeping the stool smooth. It is very important to take plenty of fluids and water while taking psyllium and extra bran. Bloating and flatulence are side effects of taking extra fiber. They may be avoided by taking methyl cellulose instead, which is a synthetic fiber product.
Some laxatives can be used safely to relive constipation. Drugs which contain lactulose, sorbitol or polyethylene glycol are usually used. Stimulant laxatives which contain glycerin or bisacodyl, as well as a new drug named lubiprostone, are also found to be beneficial.
Abdominal pain can be treated with muscle relaxants that work on the gastrointestinal muscles. Dicyclomine is effective in reducing pain, but being an anticholinergic drug, it may precipitate many side effects including blurring of vision, difficulty in passing urine and dry mouth.
The drugs loperamide or diphenoxylate are usually used to relieve diarrhea. Another drug used is alosetron which reduces the effect of the neurotransmitter serotonin. Peppermint oil is an active ingredient in formulations which help reduce abdominal cramping and flatulence. Cognitive-behavioral therapy, hypnosis, and other techniques to change behavior patterns are found to be effective in managing symptoms in people with IBS. Psychotherapy and antidepressants are included in the clinical options for managing IBS. Antidepressants in small doses are found to be effective in relieving not only the emotional symptoms such as anxiety, depression and sleep problems but also many of the physical symptoms like abdominal pain and cramping.