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Archive for " August, 2011 "

Diarrhea is a symptom of underlying gastrointestinal dysfunction. It is defined as the passage of more than 200g or 200ml of stool in three or more bowel movements within a 24 hour period. Typically there is a large volume of watery stool especially in acute diarrhea. Sometimes changes in bowel habit and stool form may not fit into the definition of diarrhea yet it is not normal for the individual. Frequent bowel movements and loose stool are two more commonly used terms to describe  these changes but may be used quite subjectively. Irrespective of the terminology, the changes are due to certain known mechanisms.


The bowels are made up of the small intestine and large intestine which are the longest parts of the digestive tract (alimentary tract or gut). The intestines are important sites of digestion and absorption of nutrients and the formation of waste material that is evacuated from the bowels as feces. Like the rest of the gut, it has a multi-layered wall that is somewhat similar in structure from mouth to anus. Within the bowels are massive populations of bacteria which help with digestion and absorption of nutrients but usually do not harm the bowels.¬† This naturally-occurring ‘good’ bacteria is known as the normal intestinal flora. The bowels are affected by a number of insults, from infectious to mechanical and chemical, but is usually able to recover once the causative factor is removed.


Rhinitis is the inflammation of the nasal passages while sinusitis is the inflammation of the paranasal sinuses, the hollow air-filled cavities in the skull that drain into the nasal cavity. Both rhinitis and sinusitis are often related since these structures have a similar type of mucosal epithelial lining and communicate with each other. Pathology in one part can therefore extend and involve the other. The treatments for both rhinitis and sinusitis, although largely depending on the cause, are similar. Congestion caused by swelling of the epithelial lining coupled with excessive mucus production is the hallmark of both rhinitis and sinusitis. In rhinitis this is usually isolated to nasal congestion, whereas in sinusitis the congestion of the sinuses also extends to the nasal cavity and passages.


There are four pairs of paranasal sinuses, which are hollow air-filled cavities, in the skull. It is believed that the sinuses play a role in making the skull lighter in weight, and allows for resonance that enhances the voice. It is a continuous with the nasal cavity, and lined with a similar epithelium that produces mucus. Most of this mucus drains into the nasal cavity and throat and ensures that there is no congestion. However, being exposed to the same environmental factors as the nasal cavity, it is also prone to the same irritants and microbes.


Hay fever is a common ailment characterized by recurrent sneezing, runny nose, nasal congestion and watery eyes and affects millions of people globally. There is often a misconception, largely due to the term ‘hay fever’, that it is caused and solely due to pollen and other botanical irritants. However, hay fever is one presentation of a constitutional immune-mediated hypersensitivity known as atopy, that is also responsible for other allergic conditions like allergic asthma and atopic dermatitis. Hay fever is more correctly known as allergic rhinitis. It can be either seasonal or perennial and must be differentiated from non-allergic rhinitis.


Blood flow to the legs, as is the case with any part of the body, is via the arteries and veins. Arteries carry oxygen-rich blood to the site, while veins transport oxygen-depleted blood away and back to the heart. Any excess fluid in the tissue spaces drains into the lymphatic vessels that eventually empties into the veins. Poor blood flow to the legs can be broadly termed as peripheral vascular disease (PVD). This includes any disease that impairs blood flow through the arteries or legs. However, the term has become synonymous with peripheral arterial disease (PAD) which is a problem with the blood flowing through an artery.


The use of terms such as gastritis, peptic ulcers, acid reflux and gastroesophageal reflux disease (GERD) can sometimes be confusing for the average person. It often leads to a person wrongly attempting to self-medicate themselves with over-the-counter (OTC) products, sometimes without even the advice of a pharmacist. In order understand the differences and similarities between these conditions, it is important to first have a basic understanding of stomach anatomy and physiology.

The stomach is a hollow organ that connects with the esophagus (food pipe) at the top and small intestine towards its bottom end. It has specialized cells in its lining that secretes mucus, enzymes, hydrochloric acid and water. This creates the stomach juices, collectively referred to as the stomach acid, helps with the process of digestion. A mucus barrier protects the lining from the corrosive action of the gastric acid. Food that enters through the mouth passes down the esophagus, is churned in the stomach and partly digested by the acid and enzymes and then passed on to the small intestine for further digestion and nutrient absorption.