Category: Health Care

Dry mouth describes any condition in which reduced secretion of the salivary glands results in inadequate saliva, and the saliva that is produced is thicker than normal. Depending on the severity of the problem, a person may have not only dryness in the mouth, but also increased thirst, dry lips, or, in the worst cases, difficulty chewing and swallowing. Taste and smell may be impaired. Because mouth dryness permits more rapid bacterial growth, tooth decay and gum disease are more likely to occur. Commonly, dry mouth is a consequence of smoking or a side effect of certain drugs, especially decongestants, antihistamines, antidepressants, atropine, and some heart and ulcer medications. Cancer chemotherapy and radiation therapy to the mouth and throat also cause dry mouth. To some degree, all older people experience this condition, because saliva production naturally declines with age.

Diagnostic Studies And Procedures

A doctor or dentist can often diagnose a salivary gland disorder simply by feeling the glands and noting the reduced moisture in the mouth. However, if the cause is not readily apparent, the physician may order blood tests to check for autoantibodies (antibodies that attack the body) and X-rays to check for structural abnormalities.

Medical Treatments

If an autoimmune disorder, such as lupus or Sjogren’s syndrome, is responsible for the dry mouth, treatment is direcled to controlling the underlying disease and alleviating the dryness. In severe cases, immunosuppressive drugs are given to halt the immune system attack on healthy tissue. If salivary glands suddenly become enlarged and painful, a painkiller with anti inflammatory action, such as ibuprofen or aspirin, may be advised. Anyone with dry mouth should see a dentist every three months for cleaning and periodontal treatmenLs to help prevent a potentially dramatic increase in dental cavities and gum disease. The dentist may recommend special preventive fluoride treatments that can be performed at home.

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Diagnostic Studies And Procedures

Diagnosis is based on symptoms and a medical history. If a doctor suspects clinical depression, she will probably refer the patient to a psychiatrist or clinical psychologist for testing.

Medical Treatments

Depression responds to medical treatment better than many other mental disorders. Approaches fall into three categories medication, psychological therapy, and electro convulsive therapy.

Psychotherapies

These “talking” treatments focus on helping patients resolve emotional problems by gaining insight into their own psychological makeup. Traditional psychotherapy looks for a childhood source of the problem, while other approaches address current conflicts and interpersonal problems. Behavioral and cognitive forms of psychotherapy teach patients new ways to view the world. Depressed people tend to expect failure and often make false assumptions about the behavior and motives of others. Cognitive therapists strive to help these patients correct their negative beliefs. Interpersonal therapy is based on the concept that depression occurs when personal relationships are disturbed, and that these relationships perpetuate symptoms, which worsen the interper sonal problems; the end result is a dysfunctional cycle. By focusing on issues, interpersonal therapists help patients understand their illness and feelings, and find ways to improve relationships.

Electroconvulsive Therapy

Although this method, often referred to as ECT or shock treatment, is not used as often as in the past, it is still highly effective in treating suicidal patients. The patient is given a general anesthetic, eliminating pain and memory of the procedure. Electrodes are placed on one or both sides of the scalp and a mild electric shock is administered to the brain, resulting in a minor seizure. There is temporary loss of memory for events of the past 6 to 12 months.

Alternative Therapies

Major or recurrent depression requires medical treatment. Alternative therapies are useful adjuncts that may be adequate for overcoming the milder forms.

Ayurveda.

This ancient method of healing from India promotes emotional and physical well being with a regimen of diet, exercise, and herbal remedies designed to correct individual imbalances.

Creative Therapies

Art, music, dance, and other forms of artistic expression are especially beneficial during recovery from depression, because they help a patient to build self steem.

Light Therapy

People who repeatedly suffer depression only during the winter have seasonal affective disorder, or SAD, associated with insufficient exposure to daylight. Typical treatment involves sitting under special lights for several hours a day .

Naturopathy and Nutrition Therapy

Diet plays a major role in brain function, but there is considerable disagreement over nutritional treatment of any mental disorder. Many nutrition therapists advise a sugar free, low fat diet that is high in complex carbohydrates and protein. Some also recommend supplements of B complex vitamins.

Self Treatment

Exercise can work as well as antide pressant drugs for mild depression or dysthemia. Aerobic exercise is especially effective, because it stimulates a release of endorphins, the body’s own pain relieving and mood lifting chemicals. It’s best to stick to normal routines, particularly if you are experiencing reactive depression. Daily chores anchor you in reality; they may also prevent deeper depression. Never overlook the power of laughter. A funny movie or an amusing book can often improve your mood.

Other Causes of Depression

Chronic fatigue syndrome has many of the hallmarks of depression. Among the elderly, symptoms of depression are often confused with dementia. An underactive thyroid can cause symptoms similar to those of depression, as can many serious illnesses; for example, depression is common following a heart attack. Medications, such as those used to lower blood pressure, frequently cause transient depression.

Painful intercourse, known medically as dyspareunia, is discomfort or pain that accompanies sexual intercourse. Depending on the cause, the pain may be mild or acute; in some cases, it makes sexual intercourse impossible. For most women, the first experience with sex is uncomfortable, usually due to the tearing of the hymen, perhaps coupled with insufficient vaginallubrication. After a period of adjustment, according to Dr. Helen Singer Kaplan, director of the Human Sexuality Program at New York Hospital Cornell University Medical Center, it is abnormal for intercourse to hurt. Dr. Kaplan has found that in about half of her patients who experience painful intercourse, the cause is physical; for the rest, emotional factors or both physical and psychological problems are responsible. Physical causes of persistent pain during intercourse include genital herpes, vaginitis, pelvic inflammatory disease, endometriosis, a displaced or tipped uterus, thinning of the vaginal tissues following menopause or during breast-feeding, and an allergic response to contraceptives. The problem can also be the result of a poorly sewn episiotomy or scarring from a childbirth injury. Among the causative emotional factors are anger, fear of pregnancy, and guilt. Childhood sexual abuse or a punitive upbringing in regard to sexual matters may be involved. Also, women who have been raped sometimes develop dyspareunia. When troubled feelings have been deeply repressed, they may lead to vaginismus; these are involuntary contractions or spasms of the vaginal muscles that make penetration impossible.

Doctors generally define a miscarriage as the natural termination of a pregnancy during the first 20 weeks of gestation. (Delivery between the 21st and 38th weeks is considered a premature birth, even if the fetus does not survive.) At least 20 percent of all pregnancies end in a miscarriage between the sixth and tenth weeks. Recent studies indicate, however, that the figure may be as high as SO percent, but that many go unnoticed because women don’t always realize they are pregnant. Typically, a miscarriage begins with aginal bleeding or a brownish discharge, which may be accompanied by cramps and lower back pain. If the woman is unaware of being pregnant, she may simply assume that she is having a heavy menstrual period. The majority of miscarriages are caused by a problem in fetal development, most often chromosomal abnormalities or structural malformations. For example, fertilization toward the end of the 24 hour period after ovulation can cause these abnormalities. Some researchers believe late fertilization is the major cause of miscarriage. Other possible causes include maternal hormone imbalances, such as those caused by thyroid disease or diabetes a. structural defect in the uterus or ervix; poor attachment of the placenta to the uterine wall; rubella or other infectious illnesses, including sexually transmitted diseases; complications from kidney disease; the presence of an IUD in the uterus; or severe emotional shock. Lifestyle factors that increase the risk of miscarriage include smoking, use of alcohol, poor nutrition, and exposure to radiation, hazardous chemicals, or lead. For many miscarriages, however, a cause cannot be found.