Sunday 23 October 2016

I Have Septic Bursitis… I Understand It Can Be Dangerous...what Is It?


Before the days of antibiotics, septic bursitis was a potentially life-threatening problem.

Nowadays, because of higher index of suspicion as well as the presence of antibiotics, it should be, in most case, readily treatable. This article discusses this problem.

A bursa (plural=bursae) is a sack containing a small amount of fluid that serves as a protective cushion between bones and overlying muscles or between bones and tendons. Bursitis is inflammation of a bursa caused by repetitive use, trauma, infection, or a systemic inflammatory disease.

These sacks are lined with the synovium – the same tissue that lines the inside of joints. Humans have approximately 160 bursae.

Bursitis most commonly affects the shoulder, elbow, hip, and knee. Symptoms of bursitis may include localized tenderness, edema, redness, heat, and limited ability to move the affected area.

When a bursa becomes infected, the condition is referred to as septic bursitis. In septic bursitis, trauma is the usual culprit. Trauma causes inoculation of bacteria into the bursa, which triggers an inflammatory response.

The two most commonly infected bursae are the olecrenon bursa at the elbow and the prepatellar bursa in the knee. The reason these two bursae get infected more easily is because of their location.

The olecranon bursa lies at the tip of the elbow. Because of its superficial location, it is easily traumatized from acute trauma or repetitive stress.

Trauma to the skin makes the olecranon a frequent location for infectious bursitis. The risk of septic bursitis increases in those who have a history of another chronic disease of dailyhealthbest.

Chronic repetitive stress from pressure on the elbows is seen in hemodialysis patients, computer users, and chronic lung disease patients.

When inflamed, the olecrenon bursa at the tip of the elbow becomes swollen, red, and painful. Bending the elbow makes the pain worse. Low grade fever and chills may also be present.

The prepatellar bursa lies in front of the knee between the patella (kneecap) and the skin.

Infection can develop due to either trauma or constant friction between the skin and the patella, most commonly when frequent kneeling is involved. It can be seen in carpet-layers, coal miners, roofers, gardeners, electricians, and plumbers. Actually any activity involving a lot of kneeling and friction can lead to septic prepatellar bursitis.

The superficial location of the prepatellar bursa allows for rather easy introduction of bacteria. This is similar to the situation involving the olecrenon bursa.

Prepatellar bursitis presents with swelling, redness, heat, and pain involving the front of the knee. Bending the knee causes increased pressure over the bursa and increases pain.

(A quick note: there is also another bursa called the infrapatellar bursa. It is located below the knee cap and may be confused with the prepatellar bursa).

As mentioned earlier, septic bursitis occurs from the introduction of bacteria through trauma. It can also occur from the spread of infection from the skin adjacent to a bursa. Skin infection is called cellulitis.

It is less likely for deeper bursae to become infected because of their location. This can occur as a result of spread from septic arthritis (an infected joint) or from bacteria carried to the bursa from the blood.

Predisposing factors include diabetes, alcoholism, steroid therapy, kidney disease, trauma, and skin disease. A history of noninfectious inflammation of the bursa (as seen in rheumatoid arthritis, gout, and pseudogout) also increases the risk of septic bursitis.

Signs that favor the diagnosis of septic over simple inflammatory bursitis include: severe tenderness, extreme redness, heat, fever, and chills.

Laboratory tests may show an increase in white blood cell count and erythrocyte sedimentation rate. Blood cultures should be obtained if deep bursal infection is suspected.

Aspiration and analysis of bursal fluid from a suspected infected bursa should be performed when possible. Certainly, the most frequently infected bursae, such as the olecranon and prepatellar bursae should undergo this procedure. The use of ultrasound makes aspiration much more accurate.

Bursal fluid culture is the most important test for diagnosis.

Fluid should also be examined for crystals. Monosodium urate crystals can be seen in gout and calcium pyrophosphate crystals can be seen in pseudogout; however, the presence of crystals does not exclude concomitant infection.

All fluid should be cultured.

Patients with suspected septic bursitis should be treated with antibiotics while awaiting culture results. Superficial septic bursitis can be treated with oral antibiotics.

Deep bursal infection will generally require intravenous antibiotics.

Staph aureus is the most common bacteria, causing more than 80% of cases. Streptococcal species account for 5-20% of cases. Other organisms are less common.

An appropriate antistaph antibiotic should be started. This should be a penicillinase-resistant penicillin, such as oxacillin sodium (Bactosill), or a first-generation cephalosporin, such as cefaclor (Ceclor). Penicillin allergic patients can be treated with erythromycin.

The length of antibiotic treatment varies with the patient and the clinical situation. Uncomplicated septic bursitis presenting within a week of infection should be treated with a 10-14 day course. Aspiration should be repeated every 1-3 days while antibiotics are being administered. Antibiotics should be continued for 5 days past sterilization of bursal fluid as seen by aspiration. Again, the use of ultrasound can help with fluid detection since aspiration of a bursa without fluid may yield very little valuable material.

Patients who are immunosuppressed require a longer course of treatment of at least 15 days.

Deep bursal infections require prolonged antibiotic therapy and surgery is often required.

Surgical intervention, such as incision and drainage is needed in complicated cases.

Monday 10 October 2016

How to Get Flatulence Cure


Although it is a natural occurrence in life, many still view flatulence as something funny and ridiculous. Because people laugh at those suffering from it, it is a state thought to be embarrassing and unpleasant. This is a condition where air passes through your rectum and comes out either noisily or smelly or both. The good news is there is a way you can get flatulence cure so that you will no longer experience the symptoms which include a bloated, gassy and unlikable explosion.

Know why you are suffering from flatulence, especially if it is uncontrollable. There may be an underlying reason behind which includes diabetes, inflammatory bowel disease or Crohn's disease. Visit your physician so that he can make you undergo tests to eliminate possible potential causes that may be serious.

At home, drink peppermint tea. The oil in this beverage shall soothe your digestive tract thus lessening the flatulence.

Know what the foods and drinks are that trigger gas and avoid them. Foods that are enriched with carbohydrates, fiber, starch and sugar and carbonated drinks such as beers, colas and sodas produce gas. Remember that there are specific kinds of food that cause flatulence in one individual than in others. Determine the food you have consumed the moment you pass gas and then avoid them when you are surrounded by people.

Lactose can cause flatulence thus eliminate this from your diet. For fourteen days do not eat dairy products. If you find your flatulence decreasing, this may be the reason for your condition. Try substituting dairy products with lactose-free alternatives such as yogurt. You can also consume lactase supplements as this digests lactose and lessens gas buildup.

Activated charcoal can also reduce flatulence. Orally take 5 grams of this every day as it sucks up excess gas in the stomach and then decreases flatulence. You can get such activated charcoal in capsule, liquid, powder and tablet forms. They are available in natural and health food shops.
 This is available at the natural food store.

Flatulence cure also includes avoiding foods enriched with fiber and fat. Foods that are fried and fatty lead to bloating and then to uncontrolled flatulence. Although fiber is essential to the body, it also heightens flatulence. It is therefore advised to take fiber moderately to limit flatulence.

Consume meals in smaller portions rather than consuming large and full meals every day. Refrain from eating once you feel full. When you overeat, this can lead to severe flatulence. The body can only digest food easily when foods come in by smaller portions. Less gas is also experienced.

Minimize air you swallow by eating slowly and avoiding smoking, candy-sucking, chewing and drinking beverages via a straw. If you have dentures that do not fit properly, this can also cause flatulence.

Work out regularly because according to tests, mild activities like walking and biking can relieve gas when you suffer from intestinal conditions such as irritable bowel syndrome. Exercise also improves food digestion according to medical studies.

Try any of these flatulence cures if you are suffering from the said condition.

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