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Showing posts with label weight loss. Show all posts
Showing posts with label weight loss. Show all posts

Friday, November 28, 2008

A Simple Guide to Salivary Gland Cancer

A Simple Guide to Salivary Gland Cancer
----------------------------------------

What is Salivary Gland Cancer?
------------------------------

Salivary Gland Cancer is a malignant disease of the Salivary glands.

Cancers affecting the salivary glands are rare.

They can occur at any age, but are more common in people over 50.

What are the causes of Salivary Gland Cancer?
--------------------------------------------------------

The cause of the cancer is unknown.

Malignant tumours of the salivary glands are rare but there are benign or non-malignant tumours of the salivary glands which are more common.

Cancer of the salivary glands cannot be transmitted to another person through the saliva.

There is no inherited gene and the cancer do not run in families.

What are the symptoms and signs of Salivary Gland Cancer?
----------------------------------------------------------

Symptoms - non-specific and silent.

In the early stage there is no symptoms.

By the the time the symptoms appeared, the cancer may be in the advanced stage.

1.swelling on one side of the face either in front of the ear or under the jaw.

2.numbness and drooping of one side of the face (facial palsy).

3.weight loss

Signs:

palpable mass under the jaw

How do you diagnose Salivary Gland Cancer?
----------------------------------------------

1. full medical history and physical examination

2. blood tests for general screeing including tumor markers

Definite diagnosis requre the following tests:

3.X-rays to show the size and position of the cancer and possible spread.

4.CAT (computerised tomography) scan of the skull and neck to detect the enlarged salivary tumors

5.MRI (magnetic resonance imaging) scan of the skull and neck to detect the enlarged salivary tumors

6.Biopsy of the affected salivary gland for examination under a microscope through a needle or surgical removal.

Salivary Gland Biopsy
-----------------------------
Biopsy of Salivary tumor may be done to determine stage of Salivary cancer:

Stage 1 :
1.Size is < 2cm

2.no spread

Stage 2
1. Size is between 2 and 4cm

2.No spread.

Stage 3
1.Size > 4cm in size

2.There may be spread into nearby soft tissue.

Stage 4a
1.Size can be any size > 4cm

2.spread to the skin, jaw-bone, ear-canal or facial nerves.

Stage 4b
1.Size can be any size > 4cm

2.spread to other nearby bones, the base of the skull or the carotid artery.

Lymph nodes spread
-------------------
Stage 0
1. None of the lymph nodes are affected.

Stage1.
1.spread to one lymph node on the same side of the neck as the tumour.

2.Size of affected node <3cm

Stage 2a
1.spread to one lymph node on the same side of the neck as the tumour.

2.Size of the node is between 3-6cm

Stage 2b
1.spread to >one lymph node on the same side of the neck as the tumour.

2.Size < 6cm in size.

Stage 2c
1.spread to one or more lymph nodes on both sides of the neck.

2.Size < 6cm in size.

Stage3
1.Size of lymph nodes > 6cm in size.

Metastases Stages
---------------------
Stage 0
No spread to other parts of the body.

Stage 1
spread to other parts of the body, such as the lungs.

What is the treatment of Salivary Gland Cancer?
------------------------------------------------

Treatment of Salivary cancer can be
1.surgery
2.chemotherapy
3.radiotherapy

The type of treatment given depend on
1.the position of the cancer,
2.the exact type of cancer,
3.the general health of the patient.

Surgery
Surgery is done to remove the salivary gland tumor.

If necessary, surgery is also done to remove any affected lymph nodes in the neck.

Radiotherapy
Radiotherapy can be used to treat salivary gland cancers.

Radiotherapy can be used in conjunction with surgery especially where there is spread to lymph nodes and other parts of the body.

Chemotherapy
Chemotherapy involve the use of anti-cancer drugs to destroy the cancer cells.

It is however not very effective in treating salivary gland cancers and is used only more for the cancer which has spread to the lungs, bones and other parts of the body.

What is the Prognosis of Salivary Gland cancer?
-------------------------------------------------

The prognosis of Salivary cancer is usually fair

1.because the cancer usually causes no early symptoms resulting in advanced or metastatic disease at the time of diagnosis.

2.Survival rates are best in the slow growing tumors.

How to prevent Salivary Gland cancer?
------------------------------------

There is no way to prevent salivary gland cancer but proper mouth hygience may hlp to prevent infections and chemicals in the mouth from causing mutations in the salivary gland cells.

Smoking should be avoided if possible.

Thursday, November 13, 2008

A Simple Guide to Kidney Cancer

A Simple Guide to Kidney Cancer
----------------------------------------

What is Kidney Cancer?
------------------------------

Kidney Cancer is a malignant disease of the kidney.

What are the causes of Kidney Cancer?
-----------------------------------------

1.Hereditary- hereditary kidney cancer is related to the Von Lindau syndrome.

2.Smoking. cigarettes smoke chemicals has been known to damage the Kidney cells

3.Uncontrolled hypertension-damage to kidney cells may contribute to Kidney cancer

4.Obesity has been found to have some causal effect

5.Age - more common in in 50-70 age group

6.Long term dialysis for kidney failure.

What are the symptoms and signs of Kidney Cancer?
-------------------------------------------------------

Symptoms - non-specific and silent.

In the early stage there is no symptoms.

By the the time the symptoms appeared, the cancer is usually in the advanced stage.

1.painless hematuria or blood in urine

2.pain in the renal flanks

3.Fever

4.weight loss

Signs:

1.tenderness in renal area of backs

2.palpable mass in the side of abdomen

How do you diagnose Kidney Cancer?
----------------------------------------------

Diagnosis can usually be made by :

History
-----------

1.hematuria

2.Renal flank pain

3.Weight loss

Liver function tests
---------------------

may show a combination of results indicative of bile duct obstruction (raised conjugated bilirubin, SGGT and alkaline phosphatase levels) in the absence of liver disease.

Ultrasound or abdominal CT
------------------------------

may be used to identify tumors.

Kidney Biopsy
---------------
biopsy of kidney may be done to determine types of Kidney cancer:

Clear Cell Type: 75%
Papillary type: 20%
Chromophole type: 4%
Others: 1%

What is the treatment of Kidney Cancer?
------------------------------------------------

Treatment of Kidney cancer can be
surgery
chemotherapy
radiotherapy
immunotherapy
biological targeted therapy
depending on the stage of the cancer.

Surgery
--------------

If the cancer is localized within the kidney , then it is surgically resectable and curable.

No treatment after surgery has been proven to prevent recurrence.

Depending on the size of the cancer, the recurrence rate varies from
10% in Stage I
60% in Stage III

Once recurrence occur then the cancer is considered as a Stage IV cancer and therefore incurable.

The aim of treatment then is palliative with emphasis to improve overall survival rates and quality of life.

Immunotherapy
-----------------

High dose immunotherapy such as interleukin may be able to cure less than 5% of the kidney cancer patients.

It is however toxic and potentially life threatening and is used for patients not suitable for surgery.

Low dose immunotherapy such as interferon is better in that it can relieve symptoms and improve quality of life for an average of 3-6 month in 15% of cases treated.

Despite its low dose the side effects can also affects the treatment of the patients such as fever, chills and loss of appetite.

Biological targeted therapy
-------------------------------------

These drugs target the growth of the cancer cells by suppressing the cellular pathways which stimulates the growth of the abnormal tumor blood vessels and the tumor cells .

These treatments have been proven to better in terms of better response and length of the disease control compared to interferon and interleukin.

There has also being an improved overall survival rate with a reduced risk of death by 28%.

Side effects are hypertension, ischemia of heart, fatigue, loss of appetite, diarrhea and loss of weight.

The approved drugs are sorafenib, sumitinib and tensirolimus.

Chemotherapy and radiotherapy
-----------------------------

Chemotherapy and radiotherapy have been found to be ineffective for renal cancer treatment.

What is the Prognosis of Kidney cancer?
-------------------------------------------------

The prognosis of Kidney cancer is poor

1.because the cancer usually causes no early symptoms resulting in advanced or metastatic disease at the time of diagnosis.

2.Median survival from diagnosis is around 1 year

3.5-year survival is lower than 5%.

4.Kidney cancer has one of the highest mortality of all the cancers.

How to prevent Kidney cancer?
------------------------------------

Avoid smoking

Reduce weight in obese patients

Control high blood pressure to prevent damage to the kidney

Avoid taking toxic substances which may damage or injure the cells of the kidney.

Wednesday, June 18, 2008

A Simple Guide to Pancreatic Cancer

A Simple Guide to Pancreatic Cancer
----------------------------------------


What is Pancreatic Cancer?
------------------------------

Pancreatic Cancer is a malignant disease of the exocrine pancreas. 90% are adenocarcinomas.


What are the causes of Pancreatic Cancer?
-----------------------------------------

1.Smoking. cigarettes smoke chemicals has been known to damage the pancreatic cells

2.Diets rich in red meat- high protein tends to stmulate more enzymes frm pancreas and cause dysfunction in the cells

3.Diabetes mellitus -damage to islets in pancreas may contribute to pancreatic cancer

4.Chronic pancreatitis has been found to have some causal effect

5.Helicobacter pylori infection -known to cause stomach cancer and also pancreatic cancer

6.Occupational exposure to certain chemicals including insecticides

7.Family history -there is a family history in 5-10% of pancreatic cancer patients

8.Obesity - the high fat diet may induce more disease of bile system with blockage of its tract


What are the symptoms and signs of Pancreatic Cancer?
-------------------------------------------------------

Symptoms - non-specific and varied.

1.pain in the upper abdomen that typically radiates to the back

2.pain relieved by leaning forward

3.painless jaundice related to bile duct obstruction (carcinoma of the head of the pancreas)

4.depression is sometimes associated with pancreatic cancer


Signs:

1.tenderness in upper abdomen

2.mass in the abdomen

3.Trousseau sign- Spontaneous blood clots in veins of extremities, or the superficial veins may indicate presence of pancreatic cancer.



How do you diagnose Pancreatic Cancer?
----------------------------------------------

Diagnosis can usually be made by :

History
-----------

1.pain in upper abdomen radiating straight to the back, worse on eating

2.Weight loss severe with anorexia, early satiety, diarrhea, or steatorrhea.

3.Jaundice -initially painless, itchy with dark urine.
Painful jaundice occurs later

4.onset of atypical diabetes mellitus

5.unexplained recent thrombophlebitis

6.past history of pancreatitis

Location of cancer
-----------------------

1.Tumors in the pancreatic body or tail usually present with pain and weight loss

2.Tumors in the head of the gland typically present with steatorrhea, weight loss, and jaundice.

Courvoisier sign
-----------------

presence of jaundice and a painlessly distended gallbladder is suggestive of pancreatic cancer

Liver function tests
---------------------

may show a combination of results indicative of bile duct obstruction (raised conjugated bilirubin, SGGT and alkaline phosphatase levels).

CA19-9 (carbohydrate antigen 19.9)
----------------------------------

is a tumor marker that is frequently elevated in pancreatic cancer.

Ultrasound or abdominal CT
------------------------------

may be used to identify tumors.

Endoscopic ultrasound (EUS) is another procedure that can help visualize the tumor and obtain tissue to establish the diagnosis.


What is the treatment of Pancreatic Cancer?
------------------------------------------------

Treatment of pancreatic cancer can be surgery or chemotherapy depending on the stage of the cancer.

Surgery
--------------

1.Where the head of the pancreas is involved, the Whipple procedure is the most common surgical treatment for pancreatic cancers.
It is a major surgery involving the the resection of the head of pancreas and requres the patient to be fit for the surgery and the tumor to be localised without metastases. Only in small number of cases can the surgery be done.

2.Cancers of the tail of the pancreas can be removes by a technique called distal pancreatectomy

3.localized tumors of the pancreas have been surgically removed using laparoscopy.

4.Surgery may be performed for relief of symptoms especially if the cancer is invading or pressing on the duodenum or colon.

5.Bypass surgery may prevent the obstruction of the pancreatic ducts and improve quality of life.

Chemotherapy
-----------------

is used for patients not suitable for surgery. It can relieve symptoms and improve quality of life

Gemcitabine was approved by the US FDA after a clinical trial reported improvements in quality of life in patients with advanced pancreatic cancer

Gemcitabine may used after surgery to remove tumor tissue remaining in the body. As a result 5-year survival rates has improved.

Other drugs such as oxaliplatin and fluorouracil have also beneficial effect.

Radiation therapy
--------------------

The use of additional radiation therapy follwing surgery has been used in USA while rejected by most doctors in Europe.


What is the Prognosis of pancreatic cancer?
-------------------------------------------------

The prognosis of pancreatic cancer is poor

1.because the cancer usually causes no early symptoms resulting in advanced or metastatic disease at the time of diagnosis.

2.Median survival from diagnosis is around 3-4 months;

3.5-year survival is lower than 5%.

4.Pancreatic cancer has the highest mortality of all the cancers.

5.Pancreatic cancer may sometimes cause diabetes.

How to prevent Pancreatic Cancer?
----------------------------------------

1.a healthy lifesyle

2.increase consumption of fruits, vegetables

3.reduce red meat intake

4.Vitamin D can reduce the risk of pancreatic cancer

5.B vitamins such as B12, B6, and folate in food but not in tablets may reduce the risk of pancreatic cancer

6.Avoid smoking and drinking of alcohol

Monday, March 3, 2008

A Simple Guide to PECOMA Cancer

A Simple Guide to PECOMA Cancer
-----------------------------------------


What are PECOMA Cancer?
-------------------------------------


Perivascular epithelioid cell tumor (PEComa) is a neoplasm composed chiefly of HMB-45-positive(a marker which is relatively specific for melanoma) epithelioid cells with clear to granular cytoplasm and a perivascular distribution.
Such tumors have been reported in different organs

Although rare, only 20 + cases worldwide, PEC tumors (PEComas) should be regarded as a tumor of uncertain malignant potential.

Who is at risk of getting PECOMA Cancers?
------------------------------------------------------------


The median patient age was 46 years (range, 15-97 years).

There is a marked female predominance (22 females, 4 males).

Sites of involvement included

1.the omentum or mesentery (6 cases),

2.uterus (4 cases),

3.pelvic soft tissues (3 cases),

4.abdominal wall (2 cases),

5.uterine cervix (2 cases),

6.vagina,(1 case).

7.retroperitoneum,(1 case).

8.thigh,(1 case).

9.falciform ligament,(1 case).

10.scalp,(1 case).

11.broad ligament,(1 case).

12.forearm, (1 case).

13.shoulder,(1 case).

14.neck (1 case).

The tumors ranged from 1.6 to 29 cm in size (median, 7.8 cm).

Tumors were
1.epithelioid (N = 9),

2.spindled (N = 7), or

3.mixed (N = 10).


What are the Symptoms of Pecoma Cancer?
---------------------------------------------------------


Among the common warning signs are:

1.weight loss,

2.pain in the bones

3.swelling of lymph nodes

4.Persistent fever

5.loss of appetite

6.generalised weakness and pallour


What are the Causes of Pecoma Cancer?
----------------------------------------------------------


Unknown.

Certain genetic abnormalities may be present.

They are more common in women
.

How do you diagnose Pecoma Cancer?
-------------------------------------------------


1.HMB-45-positive(a marker which is relatively specific for melanoma)is present in all cases

2.Perivascular epithelioid cell present on biopsy


What is the Treatment of Pecoma Cancer?
-----------------------------------------------------


The onset of PEComa Cancer has been known to be very rapid.

Because of its vascular origin, it can spread very fast.

Surgery will be useful if detected at the early stage
.

Chemotherapy and radiation therapy are the main treatment for Pecoma cancer.

Besides these treatments, stem cells infusion also give patients and their families another source for a cure.


What are the Prognosis for Pecoma Cancer?
-----------------------------------------------------------------------


Generally poor because onset is fast and spread diffuse.

Monday, December 10, 2007

A Simple Guide to Diabetes Mellitus

A Simple Guide to Diabetes Mellitus
-------------------------------------------



What is Diabetes?
---------------------



Diabetes mellitus literally means sweet urine.
It is a common chronic disease which happens when the hormone insulin produced by the pancreas is missing, lacking or not working well.


Insulin unlocks the cell to allow glucose from the bloodstream to enter the body cells for usage or storage.
When this mechanism fail, the high amount of glucose in the blood leads to the glucose being spilt over into the urine, causing diabetes.


What are the different types of diabetes?
-----------------------------------------



The main types of diabetes are
1.Type 1
2.Type 2.



Type 1 occurs commonly in children and young adults although it may occur at any age.
It is more serious because there is practically no insulin produced due to damaged pancreatic cells and therefore insulin injections is needed for treatment.
The cause is unknown.
Complications are more sudden and life-threatening.

Type 2 is
more common.
It is found in
1.adults over 40 years old,

2.overweight and

3.physically inactive.



The insulin produced is not enough or may not be working effectively.
Type 2 diabetes can be controlled by
proper dieting and exercise.
Most Type 2 diabetics will also need oral medication.


Gestational diabetes occurs only in pregnancy but may be an indicator of diabetes later in life


What are the risk factors for diabetes?
----------------------------------------------



Diabetes is more likely to occur if you have:


1.Obesity (body mass index > 23)

2.family history of diabetes

3.hypertension (>140/90 mmHg)

4.previous gestational diabetes

5.Coronary heart disease

6.polycystic ovary disease

7.Hyperlipidemia(high blood cholesterol >5.2 mmol or 220mg/dl and
tryglycerides >2.30)

8.Inadequate regular exercise

9.age above 40 years,more common in males than females

10.smoking habit

What are the Signs and Symptoms of Diabetes?
-------------------------------------------------------



The following symptoms are typical of diabetes:


1.frequent thirst even after drinking lots of water


2.passing more frequent urine during day and night


3.weight loss while having good appetite


4.constant tiredness


5.poor healing of skin wounds

6.
itchy skin particularly around the genital area


7.constant hunger


8.blurred vision

Note that
some diabetics may not experience any symptoms at all.

How do you made the diagnosis of Diabetes?
----------------------------------------------------

Blood glucose test:

1.
Random blood glucose (anytime) is 11.1mmol/l or higher


2.Fasting blood glucose (after 8 hours of overnight fast) is 7.0mmol/l or higher.


3.Oral 75g Glucose Tolerance Test show presence of diabetes


How does diabetes cause complications in the body?
--------------------------------------------------------------



The high blood glucose concentration in diabetes reduces the blood flow to many organs and nerves resulting in many organ damage especially the kidney, heart, brain, eyes and nerves.

The high blood glucose
allows germs to proliferate because the glucose provides nutrition to the germs.


All these lead to many serious complications:


1.high blood pressure,

2.heart attack,


3.stroke,

4.kidney failure,

5.blindness,

6.impotence,

7.numbness of hands and feet,

8.infections with poor healing,

9.wounds on feet that do not heal

10.coma,


Treatment of Diabetes will dealt with in the Part 2.

Wednesday, August 22, 2007

A Simple Guide to Rheumatoid Arthritis







A Simple Guide to Rheumatoid Arthritis
-----------

What is Rheumatoid Arthritis?
-----------

Rheumatoid arthritis is a systemic autoimmune disease that can cause chronic inflammation of the joints and other areas of the body.

Who gets Rheumatoid Arthritis?
--------------------------------------

Rheumatoid Arthritis is one of the most common form of inflammatory arthritis.
It most commonly occurs between the 25 and 50 years.
However it can occur at any age.
Females are 3 times more likely to get Rheumatoid Arthritis than males.

What causes Rheumatoid Arthritis?
-------------------------------------------

Rheumatoid Arthritis is an autoimmune disease..
Autoimmune diseases are illnesses that occur when the body tissues are mistakenly attacked by its own immune system which consists of cells and antibodies designed normally to "seek and destroy" invaders of the body, particularly infections.
Patients with autoimmune diseases have antibodies in their blood that target their own body tissues .

What are the symptoms of Rheumatoid Arthritis?
-----------------------------------------------------------

Most common symptoms are pain, swelling, stiffness, warmth and sometimes redness of the joints.

Rheumatoid Arthritis is suspected when there are:
1. Swelling in the joints especially those of the hands,elbows,knees,ankles and feet.

2. Stiffness in the joints in the mornings which can last more than an hour or after prolonged rest

3.redness and warmth in one's joints

4.Persistent pain or tenderness in a joint for more than a month

5.Inability to move or use a joint normally

6. Unexplained weight loss and appetite, fatigue, or weakness together with joint pains

What tests are done to confirm Rheumatoid Arthritis?
----------------------------------------------------------------

Abnormal blood antibodies can be found in patients with rheumatoid arthritis.

1.A blood antibody called "rheumatoid factor" can be found in 80% of patients.

2.Another antibody called "the antinuclear antibody" (ANA) is also frequently found in patients with rheumatoid arthritis.

3.Another blood test that is used to measure the degree of inflammation present in the body is the C-reactive protein.

4.A blood test called the sedimentation rate (ESR) is a measure of how fast red blood cells fall to the bottom of a test tube. The sed rate is used as a crude measure of the inflammation of the joints.

The rheumatoid factor, ANA, sed rate, and C-reactive protein tests can also be abnormal in other systemic autoimmune and inflammatory conditions. Therefore, abnormalities in these blood tests alone are not sufficient for a firm diagnosis of rheumatoid arthritis

How does the Rheumatoid Arthritis starts?
--------------------------------------------------

Rheumatoid Arthritis may start gradually or with a sudden and severe attack.
It usually attacks many joints at one time.
Rheumatoid arthritis is a chronic disease, characterized by periods of disease flares and remissions.

Where does Rheumatoid Arthritis occur?
-------------------------------------------------

In rheumatoid arthritis, multiple joints are usually affected in a symmetrical pattern.
It most commonly affects the hands and feet,often in a systemic pattern(both right and left joints are affected).
Other joints affected are the elbow,knees,and ankles.
Less common are shoulder,hip and spine.

What are the Complications of Rheumatoid Arthritis?
----------------------------------------------------------------

Rheumatoid Arthritis can result in joint deformities and disability especially in untreated severe cases.
Daily activities such as bathing,dressing, walking and even writing may be difficult.
Besides the joints, Rheumatoid Arthritis may sometimes affect other organs such as the eyes,lungs,skin,intestines,nerves and bone marrow.
Mild fever, fatigue, loss of appetite and loss of weight may be present.
Severe Rheumatoid Arthritis is associated with an incresed risk of mortality.

How is Rheumatoid Arthritis treated?
--------------------------------------------

There is no known cure for rheumatoid arthritis.
Therefore the purpose of treatment is to:
1. improve functions and
2. reduce pain and discomfort.

Treatment of Rheumatoid Arthritis can be broadly classified into:
1. Non-drug therapy:
Weight loss is an effective way to reduce the stress on the joints and minimise the pain Walking sticks are useful ways to offload the stress on the affected weight bearing joints such as hips or knee.
Hot packs are useful aids in the morning to soften a stiff arthritic joint whereas braces and knee guards are useful supports to give some comfort to the knee.
Exercises that improve strength, agility and flexibilty are useful to minimise the disability of Rheumatoid Arthritis. A range of motion exercises is useful to keep the joints supple and mobile.
Water based exercises are a good alternative form of aerobic workout by patients afflicted by Rheumatoid Arthritis. The warm water especially is a good medium for joint mobility and together with the buoyancy of water it helps to minimse the body weight impact on the joints.
2. Drug therapy

There are 2 main types of drugs:
1. symptom modifying helps to alleviate the symptoms but do not change the natural history of the conditions. Examples are Non-steroidal Anti-inflamatory Drugs(NSAIDS) like diclofenac.

2. disease modifying drugs such as steroids, methothrexate, sulphasalazine, redaura, hydroxychloroquine have been shown to slow down the damage caused by Rheumatoid Arthritis. However they cause a lot of side effects such as anemia, abnormal white cells, kidney damage,liver damage, vision loss so the medications must be monitored all the time.
It is important that the disease should be controlled before irreversible joint damage occurs.

Newer "second-line" drugs for the treatment of rheumatoid arthritis include leflunomide (Arava), and the "biologic" medications etanercept (Enbrel), infliximab (Remicade), anakinra (Kineret), and adalimumab (Humira).

3. Surgery

Surgery is used as a last result to correct deformities and reduce disability.

The treatment of rheumatoid arthritis optimally involves a combination of patient education, rest and exercise, joint protection, medications, and occasionally surgery.

Early treatment of rheumatoid arthritis results in better outcomes.

Saturday, August 11, 2007

A Simple Guide to Ankylosing Spondylosis


A Simple Guide to Ankylosing Spondylosis

What is
----------
Anklyosing
-------------
Spondylosis?
----------------


Ankylosing Spondylosis is a chronic inflammatory disease of the joints of the spine. manifested by fusion(ankylosing) and inflammation(spondylosis) of some or all of the joints and bones of the spine.

It is a painful progressive disease affecting mainly the spine. It can also affect other joints, tendons,ligaments, also other areas such as eyes,lungs,bowels and heart.

Who get Ankylosing Spondylosis?
---------------------------------------

Every one can get Ankylosing Spondylosis.The age of onset is usually in the late teens or early 20's.

It is also more common in men than women about 5:1.
In men the spine and pelvis are most affected.
In women the pelvis,hips,knees,wrists and ankles are more common.

How does Ankylosing Spondylosis occur?
------------------------------------------------

Inflammation occurs at the attachment of the ligaments and tendons to the bone.
Erosion of the bones occur at the site.

When the inflammation subside, new bone develop and replaces the elastic tissues of the ligaments or tendons.

Fusion of bones occur leading to restriction of movement. This usually starts in the vertebra of the spine followed by the pelvis, then upwards to the chest wall and neck.


What are the Symptoms?
-----------------------------

The onset is usually gradual with occasional back pain over weeks or months.
Early morning stiffness and pain occurs,then wears off during the day.

It gradually becomes worse ,affecting the lower back first then upwards to to the neck, resulting in stiffening of the whole back.

Chest expansion can become limited because of the the stiffness of the bones.
Sometimes peripheral joints such as shoulders and hips are affected.

Weight loss and fatigue may occur in the early stages.

The blood Erythrocyte Sedimentation Rate is raised in most cases.
The blood Rheumatoid Arthritis factor is not present.

Does Ankylosing Spondylosis occur in other organs?
-------------------------------------------------------------

It can sometimes affect the eyes, heart and lungs.
These effects are not life-threatening and they can be treated with relative ease.

Inflammation of the iris of the eye(Uveitis) occur in 5% of cases with blurring of vision. Occasionally it may affect the heart causing the aortic valve to leak.

The rib joints and muscles are also affected resulting tightness of the chest making breathing painful.

How is Ankylosing Spondylosis diagnosed?
--------------------------------------------------

Classical features of symptoms with stiffening of spine and back pain usually suggest the diagnosis.
Confirmation is usually by an x-ray of the spine and pelvis.

How to treat Ankylosing Spondylosis?
--------------------------------------------

Not every patient suffer the same degree of symptoms. Some may be very mild requiring only exercises or mild pain killers.

Others may be more severe requiring strong NSAIDSor anti-rheumatoid drugs such as sulphasalazine .

ANTI-TNF drugs( a new therapy) has also been found to help improve the Rheumatoid Arthritis patients and also Ankylosing Spondylosing patients.

What is the prognosis of Ankylosing Spondylosis?
----------------------------------------------------------

Symptoms comes and go.

With exercise and NSAIDSpain is reduced considerably and flexibility of the spine is improved especially with regular exercise and proper posture.

Ankylosing Spondylosis is never life threatening and can be controlled but not cured.

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