Mention E. coli in a roomful of people, and you will see fear and concern on many faces. Public awareness of this lowly bacterium has risen dramatically in the last few years. This interest springs from E. coli outbreaks that have happened too frequently around the globe. In 2006, an E. coli outbreak originated when baby spinach sickened 204 people in 26 states and involved three deaths. An episode in Scotland killed seven people and infected several hundred others. What makes it so alarming is its invisibility, since E. coli has no offending taste or smell. Also, the contaminated food doesn’t give any hint to the eye that it has been tainted and can even look wholesome, such as that bagged baby spinach.

What is E. coli?

E. coli (Escherichia coli) are named after a German pediatrician and bacteriologist, Theodor Escherich, who discovered it in 1885. Coli are a reference to bacteria which grows in the colon, and there are many different types of E. coli. Harmless E. coli is present in the intestines of people and animals. However, three strains of the bacteria create potentially lethal toxins, 0157:H7, 0121, and 0104:H21. The bacteria are often used in experiments because they survive well outside the body, and they grow easily in a laboratory. In addition, their genetics are simple and easily manipulated.

How do you get E. coli?

E. coli infections usually originate from the following sources:

• Drinking water which is contaminated
• Drinking unpasteurized milk, apple juice, or apple cider
• Eating ground beef that’s undercooked
• Working around cattle
• Person to person contact often in day care centers or nursing homes
• Swimming in contaminated water

Ground beef should always be cooked thoroughly and never contain any pink color inside where the bacteria can survive. People who are infected with E. coli are highly contagious and need to take precautions not to infect others.

Eating meat that's not cooked thoroughly is a major cause of getting E. Coli

Symptoms of an E. coli infection?

Symptoms of E.coli often start about seven days after the bacteria have entered your system. Suddenly, you may come down with severe abdominal cramps, followed in a few hours by watery diarrhea. Your body will become dehydrated from the loss of fluids. After a day, the watery diarrhea becomes bloody from sores in the intestine, and this may last from two to five days. There may be ten bowel movements a day, and people often say they consist mostly of blood. Along with these symptoms, you may run a slight fever, feel nauseous, and have vomiting. It is important to consult your doctor immediately if you experience any of these symptoms because life-threatening complications can develop. Diagnosis can be made from a stool culture.

E. coli Treatment

Your body needs to rid itself of the invading bacteria naturally, so don’t take medicines to stop the diarrhea, unless your doctor has prescribed them. Drink a lot of water to keep hydrated and help flush the bacteria from your system. Antibiotics don’t often work against E. coli infections because some strains are resistant to them. Be alert to complications which can develop from an infection.

What are the complications of the E. coli infection?

Hemolytic uremic syndrome is the most common complication and is often found in children with E. coli. It can lead to acute renal failure. It usually begins about five to ten days after the start of the diarrhea. Patients develop a low red blood cell and platelet count, and kidney damage. The patient needs immediate medical care and hospitalization.

Prevention Measures against E. Coli

• Wash your hands thoroughly after using the bathroom or changing a diaper
• Wash your hands after handling animals, or any material which may contain animal feces.
• Thoroughly cook ground beef, pork, sausage, and other meats to 155° F.
• Always keep raw meat separate from other foods to prevent cross contamination
• Do not drink unpasteurized milk
• Thoroughly was fresh fruits and vegetables before eating
• Wash hands, cutting boards, counters, and utensils after contact with raw meat
• Don’t taste ground beef as you are cooking
• Refrigerate leftovers immediately or throw them away

Written by Joy Seeman,

© Hemorrhoid Information Center

Sources:

E. Coli. (2009, July 28). Retrieved January 27, 2010, from Mayo Clinic: http://www.mayoclinic.com/health/e-coli/DS01007

E. Coli Infections. (2010, January 21). Retrieved January 27, 2010, from Medline Plus. http://www.nlm.nih.gov/medlineplus/ecoliinfections.html

Many people suffer in silence that have hemorrhoids because they are too embarrassed to see a  doctor. Social taboos are associated with this part of our body and we are conditioned to keep any problems with bathroom habits to ourselves. The fear of being ridiculed for having hemorrhoids is enough to keep this condition in our own personal closet forever.  Yet, if you suspect that you have hemorrhoids, you do need to get a diagnosis from your doctor. Remember that doctors are not there to embarrass you, and they routinely perform these examinations all the time.  There are many other conditions that could be causing your symptoms, such as rectal cancer or anal fissures.  Your life is too valuable to gamble with, so always go to your doctor to make sure what you are dealing with is a hemorrhoid. It is one thing to be embarrassed, and quite another thing to have a different disease which could be life-threatening.

Even though you may feel uneasy, seeing a doctor is the right choice!

The doctor will be able to visually identify prolapsed and external hemorrhoids, and then, will examine the interior of the rectum. If you have  internal hemorrhoids they usually can be felt by a digital rectal exam. With this exam, the doctor will insert a gloved lubricated finger into the rectum where they can feel any abnormalities. If the doctor needs to examine the inside of  the rectum visually, they will use an anoscope. An anoscope is a hollow lighted tube useful for viewing internal hemorrhoids.

To rule out any other causes of gastro-intestinal bleeding, the doctor may have you return for a more complete examine of the rectum and colon. A sigmoidoscopy or colonoscopy are diagnostic procedures that involve the use of lighted, flexible tubes inserted through the rectum. These two exams would not be done on your first visit, unless you have gone through the pre-op care required beforehand. Your digestive system would need to be cleansed of all fecal matter for these exams. A sigmoidoscopy can exam half the colon for abnormalities, and it is usually done in the doctor’s office.  In contrast, a colonoscopy exams the whole length of the colon, and is performed in a hospital or outpatient surgical setting.

written by Joy Seeman

© Hemorrhoid Information Center 2009

What is Ulcerative Colitis

Ulcerative Colitis is one of the most prevalent Irritable Bowel Syndromes (or IBSs) diagnosed today amongst adults in the United States.  The disorder occurs when the lining of the colon becomes compromised due to persistent inflammation, thus breaking down the cells in the colon wall and thereby forming lesions or sores in the anus, also known as ulcers.

Who Does Ulcerative Colitis effect

Ulcerative Colitis affects individuals differently, depending on a variety of considerations, including the status of one’s health, in addition to their family history and hereditary factors.  Because cases are not identical regarding exact causes and symptoms, no two treatments are identical.  However, because causal similarities are consistent amongst sufferers, in addition to the presence of fairly predictable symptoms, remedy options tend to follow certain trends.  Typically drug treatment options are the first measures advised.  Three drugs that are frequently prescribed to help alleviate symptoms are a) Aminosalicylates, b) Corticosteroids, and c) Immunomodulators.  Compounds that include what are called 5-aminosalicylates help to reduce symptoms of inflammation.  An example of a 5-aminosalicylate is a drug composed of two agents, respectively Sulfasalazine and sulfapyridine.  Because one or more of these chemicals is known to induce unpleasant side-effects such as nausea, diarrhea, heartburn, vomiting, indigestion and migraines, 5-ASA compounds will often be augmented with other agents such as olsalazine or balsalazide, which carry fewer side-effects.  5-ASAs can be administered rectally, through an enema or suppositories, or taken orally.  In mild or moderate cases the condition is often first combated with one or more combinations of these of substances.

Ulcerative Colitis and Steroids

Ulcerative Colitis treatment also responds favorably to the use of Corticosteroids (or steroids), of which hydrocortisone and prednisone are two examples.  These agents also possess anti-inflammatory properties, and are frequently turned to for relief when individuals with moderate to severe colitis do not respond favorable to 5-ASAs.  Like 5-ASAs, corticosteroids can be taken orally or employed rectally, but can also be administered intravenously.  Side-effects from using steroids can be severe, and may include changes in skin composition resulting in acne, weight gain, in women the development of facial hair, reduction of bone mass, and a heightened vulnerability to infection.  In rarer cases diabetes can develop, which is why the use corticosteroids must be closely supervised by a doctor.  Immunomodulators, of which azathioprine is an example, lessen inflammation by acting on the immune system.  Immunomodulators such as azathioprine and 6-mercapto-purine (or, 6-MP) can be administered in cases where individuals have not responded to either 5-ASAs or to corticosteroids.  Drawbacks of taking Immunomodulators include complications regarding hepatitis, a heightened risk for developing infections, a heightened risk of succumbing to pancreatitis, and also the fact that benefits derived from the drug can take six to nine months to develop.  In addition to these treatment options, one’s physician can also prescribe medications to address issues of infection or nausea, in addition to medications that combat symptoms of diarrhea or pain.

Ulcerative Colitis in very severe and rare cases may require hospitalization.  In the event an individual experiences copious bleeding or diarrhea that is intense enough to generate dehydration, it might become necessary to rehydrate the body of its fluids or undergo transfusion treatment to address the loss of blood.  In these cases dietary needs may necessitate intravenous feeding for a period of time during recovery, administering specific medications or even surgery.  It has been estimated that approximately one quarter to forty percent of individuals suffering from severe and prolonged Ulcerative Colitis will eventually have to undergo surgery to have their colons removed.  If this becomes a necessity it is the result of massive hemorrhaging, rupturing of the colon itself, or in cases where the risk of cancer is either high or malignant polyps have already developed.  There are two procedures that are performed in such cases: an Ileostomy and an Ileoanal Anastomosis.  Respectively, an ileostomy involves making a small incision in the abdomen, through which a small section of the intestine, or ileum, is drawn.  In this way solid waste bypasses the rectum and is eliminated instead into a small pouch to which the section of intestine is fastened, where the stool then collects and can be emptied as necessary.  In contrast to the ileostomy, ileoanal anastomosis provides for the individual to maintain normalized bowel movements.  This procedure involves removal of the colon, while leaving intact the rectal muscles.  The surgeon creates a small pouch with material from the ileum in rectum in which waste is stored, and in this way allows for normal elimination of stool from the body.  Not every surgical procedure or medication regiment is appropriate for every person.  The procedure or drug therapy regiment one opts for should take into account what stage the disease is in, the severity of its symptoms, the individual’s genetic make-up, hereditary factors, and the general state of their health.  If faced with this decision one should acquire as much information as possible by consulting their physicians to best ensure they have explored and decided upon the appropriate treatment course to effectively resolve their specific case of Ulcerative Colitis.

David Gilbert received his BA from U.C.L.A. He is currently doing graduate work in psychology at California Graduate Institute, in Los Angeles, CA. Throughout his career in the mental health field he has worked clinically with several populations, and also contributed to academic works whose topics address both health and mental health issues.

Irritable Bowel Syndrome – H.I.C ©

Diabetes can produce a lot of serious medical complications, and some of these short-term complications include hypoglycemia and hyperglycemia. Both medical conditions are dangerous and are caused by abnormal glucose levels in the blood. Glucose is an important ingredient for normal body functioning. They are the body’s main source of energy, and controlling proper levels is essential for a healthy body.

People with diabetes have a problem maintaining normal levels of glucose. When glucose levels are abnormally high, they are said to be suffering from hyperglycemia. However, diabetics may also suffer from low-blood glucose levels, or what is termed as hypoglycemia.

What is Hypoglycemia?

A few hours after taking your insulin, you feel weak, dizzy and your skin feels cool and clammy. You might also feel lightheaded and short of breath even after a few minutes of walking. If you are a diabetic and you feel these symptoms, then you might be suffering from a medical condition called hypoglycemia.

Also called low-blood sugar, hypoglycemia is a medical condition wherein a person is found to be suffering from abnormally low levels of glucose in the body. Glucose is the product of carbohydrates; the higher the amount of carbohydrates found in food, the greater the amount of glucose in your blood. The amount and type of food taken directly affects blood glucose levels. This is especially true for diabetics who have a hard time maintaining proper levels because of insufficient amounts of insulin

People who have hypoglycemia have low-blood glucose levels and as a result suffer from fatigue and hunger. Glucose is needed by the body for energy and fatigue sets in when there are not enough sources of energy. Hunger is the body’s natural reaction when energy levels are low, and food is eaten to compensate for the body’s energy needs.

Glucose

Glucose is like fuel which powers the cells of your body. Without it, cells starve and eventually weaken the body. Carbohydrates are the main source of glucose, and they come from a wide variety of foods like fruits, vegetables, sugars and grains. Depending on what type or amount of food eaten, the levels of carbohydrates directly affect the amount of glucose found in the body.

Are you at risk?

Hypoglycemia is not only found in people with diabetes, this is also a symptom of other digestive and metabolic disorders. This condition is commonly found in people with diabetes and could easily be treated or managed. Knowing the early signs of hypoglycemia is important to avoid its many complications and long-term effects.

People with poor-eating habits and unhealthy diets are also prone to episodes of hypoglycemia. When the body is starved of its energy requirements, this causes hypoglycemic episodes. Patients who secrete abnormally high amounts of insulin also cause glucose levels to drop. This depletes reserve levels of glucose leaving them with inadequate sources of energy. Tumors in the pancreas where insulin is produce may also cause high secretion of insulin to be released in the bloodstream.

What happens if I have low-blood sugar levels?

Of all the major organs in the body, the brain is most susceptible to low-glucose levels. Glucose is the brain’s only source of energy and long-term effects of low-glucose levels may cause permanent brain defects. The brain depends exclusively on this sugar and cannot produce its own glucose. When blood-sugar levels fall below normal, the senses also drop.

When blood-sugar levels drop below 50-60 mg/dl patients may experience most of these symptoms:

• Irritability
• Intense hunger
• Cold clammy skin
• Severe sweating
• Weakness
• Rapid heart beat
• Low blood pressure
• Confusion
• Tremors
• Blurring of vision

It can lead to drowsiness, coma and seizures if you do not do something to raise your blood sugar.

Management and Immediate Treatment of Hypoglycemia

Emergency treatment of hypoglycemia includes restoring normal glucose levels in patients. This could be done by consuming four teaspoons of sugar which could be readily absorbed by the body. Patients are also advised to drink half a can of any juice or soda. Sports drinks like Gatorade could also be a good source of emergency sugars and can help restore glucose levels faster.

Eating cookies or other sweet pastries does not help in cases of hypoglycemia. These takes a long time before the body can convert the sugar and fats into glucose. Bouts of hypoglycemia require quick and immediate supplies of glucose.

When the episode has been controlled, a long-acting carbohydrate such as a sandwich is recommended.  This will maintain the body’s normal blood sugar levels.

In emergency cases where for some reason you can’t take anything by mouth, injection with glucagon is advised. If a glucagon injection is not available, patient should be immediately rushed to a nearby hospital for an intravenous administration of glucose.

When you have diabetes, you should always carry an identification bracelet or information in your wallet informing people about your condition. When you feel the early symptoms of hypoglycemia, it is recommended that you immediately consume emergency sources of glucose. Carrying a glucose source with you at all times can save your life. Diabetics are advised to manage their diet and medication in preparation for physical activity in order to avoid episodes of hypoglycemia.

Regular visits to a doctor are highly recommended, so that changes to diet and insulin adjustments can be made if you are experiencing recurrent hypoglycemia.

written by, Ronald Uy, RN

© Hemorrhoid Information Center 2009

Sources:

Hypoglycemia. Retrieved December 11, 2009 from MedicineNet.com: http://www.medicinenet.com/hypoglycemia/article.htm

Hypoglycemia. Retrieved December 13, 2009 from MedlinePlus: http://www.nlm.nih.gov/medlineplus/hypoglycemia.html

Hypoglycemia. Retrieved December 13, 2009 from MayoClinic.com: http://www.mayoclinic.com/health/hypoglycemia/DS00198