May
25
Cymbalta (Duloxetine)
May 25, 2011 | Leave a Comment
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Generic for Cymbalta is Duloxetine and it is an active ingredient of this depression treatment drug. Before you buy Cymbalta online without a prescription, it is recommended to consult a doctor and have his/her confirmation that this drug is for you. Also, full Cymbalta information will be attached to your order. Buy cheap Cymbalta online without rx and save both time (no need to visit a doctor to get prescription for Cymbalta every time you want to purchase it) and money - online Duloxetine is cheap having the same high quality.
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May
9
Signs and Symptoms of Depression. Antidepressants (Depression Medication) List. Generic Antidepressants Online
May 9, 2011 | Leave a Comment
What are the general symptoms of depression? What are depression signs? What are the most popular antidepressants? Where can I buy antidepressants online? Before buying antidepressants online from an internet pharmacy you should first of all learn the typical signs and symtoms of depression. After consulting tour doctor you can purchase antidepressants online and even save money buying a generic version of brand drugs, which are exactly the same drugs.
Almost everyone knows what it’s like to feel sad. Losing a pet, a friend, or a loved one is devastating. Being fired or getting a divorce can send you into a tailspin. An accident or a serious disease affects not only the physical body but also the psyche. It can be as if darkness has settled into your bones and sucked the joy right out of the marrow.
Most of us eventually recover from the boulders that are dropped on us. But some people never manage to dig themselves out of a hole. According to the National Institute of Mental Health, major depression affects about 15 million people each year. One in five of us will experience some form of depression sometime during our lifetime.
When the fog descends, people may forget what it’s like to feel happy. Sleep becomes next to impossible or all you want to do. Food loses its appeal and its flavor. Those with major depression often have a low energy level; they find it hard to mobilize themselves to finish projects or visit friends or family. They feel gloomy and down in the dumps for weeks or even months. They doubt their abilities and feel pessimistic much of the time. Just remembering simple things becomes an overwhelming challenge. They may experience thoughts of suicide—a hallmark of major depression. Such a mood disorder requires professional help immediately.
SIGNS OF DEPRESSION
• Feeling sad, gloomy, or “empty” for more than a few weeks
• Feeling hopeless
• Feeling helpless or worthless
• Insomnia, early-morning wakening, or persistently sleeping too much
• Feeling worn-down, fatigued, or like you’re moving in slow motion
• Loss of appetite: eating because it’s necessary rather than because the food tastes good and satisfies hunger
• Loss of interest in sex
• Restlessness or agitation, pacing the floor
• Difficulty with concentration and with remembering simple things; indecisiveness
• Physical complaints such as headache or pain that don’t get better when treated
• Thoughts of death or suicide to you or someone you care about, seek highly qualified assistance right now!
Digging out from a depression should never pull be a do-it-yourself project. You cannot put yourself up by the bootstraps or tough it out on your own.
Chronic depression increases the risk for heart disease, stroke, diabetes, and other serious conditions and must not be ignored. The suggestions we will widiscuss in this article are meant to supplement whatever your health professional may offer you in the way of help.
As remarkable as this may sound, some people actually coped surprisingly well with depression 50 to 100 years ago. They intuitively knew that there were some strategies that worked. For one thing, they looked around for someone to talk to. It might have been a pastor, a friend, a neighbor, or a relative. If they could afford it, they went to a psychologist or psychiatrist for counseling. Just talking things out sometimes seemed to help.
People also exercised. It might have been a physically exhausting task like chopping wood, hoeing a field or hiking through the woods. In those days, people spent more time outdoors working hard and walking from here to there. Nowadays we go from the air-conditioned comfort of our house or apartment to the air-conditioned comfort of a car, bus, or train to the air-conditioned comfort of an office or mall. We rarely spend time outside in the sun, and the only “workout” we get is at the gym or health club.
Oh yes, there was one more thing. In the good old days, especially during the winter, mothers made their kids swallow a spoonful of cod liver oil. It was never clear exactly what cod liver oil was good for, but mothers seemed to know that fish oil had beneficial properties. It was just “good for you,” no matter how bad it tasted.
Well, it turns out that virtually all of those quaint old strategies have now been proven helpful against depression. As you will learn shortly, research has shown that fish oil, exercise, light exposure, and cognitive behavioral therapy are surprisingly effective in dealing with depression.
Today medical treatment of depression by best antidepressants is usually prescribed by doctors all over the world. Below there is a list most popular and effective antidepressants available on the market today. In brackets there are given the active ingredients and each medicine is provided with the dosage information.
You can buy these common antidepressants online without a prescription from on line generic pharmacy. No rx needed to purchase antidepressants online, but it is wise to study antidepressants information before making your generic antidepressants order.
Abilify (Aripiprazole) 10, 15, 20 mg
Asendin (Amoxapine) 50, 100 mg
Bupron SR (Bupropion) 150 mg
Celexa (Citalopram) 40, 10, 20 mg
Cymbalta (Duloxetine) 20, 30, 40 mg
Desyrel (Trazodone) 25, 50, 100 mg
Effexor (Venlafaxine) 37,5, 75 mg
Effexor Xr (Venlafaxine) 150, 75 mg
Elavil (Amitriptyline) 10, 25, 50 mg
Endep (Amitriptyline) 10, 25, 50, 75 mg
Eskalith (Lithium carbonate) 300 mg
Fludac (Fluoxetine) 20 mg
Fluoxetine (Fluctin) 20 mg
Geodon (Ziprasidone) 40, 80, 20 mg
Lexapro (Escitalopram) 10, 20, 5 mg
Luvox (Fluvoxamine) 100, 50 mg
Nortriptyline (Nortriptyline Hydrochloride) 25 mg
Pamelor (Nortriptyline) 25 mg
Paxil (Paroxetine) 10, 20, 30, 40 mg
Paxil Cr (Paroxetine) 12,5, 25, 37,5 mg
Prozac (Fluoxetine) 10, 20, 40, 60 mg
Remeron (Mirtazapine) 15, 30 mg
Risnia (Risperidone) 2 mg
Risperdal (Risperidone) 1, 2, 3, 4 mg
Seroquel (Quetiapine) 25, 50, 100, 200, 300 mg
Sinequan (Doxepin) 10, 25, 75 mg
Tofranil (Imipramine) 25, 50, 75 mg
Venlor (Venlafaxine) 75 mg
Wellbutrin (Bupropion) 150 mg
Wellbutrin SR (Bupropion) 150 mg
Zoloft (Sertraline) 25, 50, 100 mg
Zyprexa (Olanzapine) 2,5, 5, 7,5, 10, 15, 20 mg
Jul
16
Depression. Diagnosis, Treatment and FAQ.
July 16, 2009 | Leave a Comment
Drug Therapy
Fifty years ago “talking therapy” was considered essential in the treatment of depression. Psychologists and psychiatrists saw lots of patients who suffered from mild to moderate depression. But during the 1970s biological psychiatry took off. The medical profession embraced the theory that depression was primarily caused by an imbalance of chemicals in the brain. Many health professionals adopted the belief that a depressed person only needed antidepressant medication to normalize brain biochemistry. All you had to do was “feed your head” the right chemicals and the depression would disappear.
During those heady days many patients were given tricyclic antidepressants to soothe their troubled psyches. Medications like amitriptyline (Elavil), desipramine (Norpramin, Pertofrane), doxepin (Adapin, Sinequan), imipramine (Janimine, Tofranil), and nortriptyline (Aventyl, Pamelor) were prescribed in huge numbers. Never mind that such drugs caused drowsiness, fatigue, constipation, dry mouth, dental problems, weight gain, blurred vision, urinary difficulties, dizziness, disturbed concentration, impaired memory, mental confusion, sexual dysfunction, and impotence.
Although these medications did help many people get out of the depths of despair, the side effects were sometimes as depressing as the depression itself. Imagine what it would be like to put on 30 or 40 pounds, feel mentally cloudy and constipated most of the time, and have no sex life. But insurance companies liked these medications. It seemed far more cost-effective to have an internist or a family practice doctor prescribe an antidepressant than to approve a lengthy series of counseling sessions with a psychologist or psychiatrist.
Then along came Prozac (fluoxetine). In 1987 when it was introduced, this antidepressant hardly made a splash. First-year sales were just barely respectable, but more than doubled in the second year. By the third year, Americans spent more on Prozac than on all other antidepressants combined. Everyone seemed to fall in love with Prozac—physicians, pharmacists, patients, and, most of all, the big payers (insurance companies and HMOs).
Prozac—a selective serotonin reuptake inhibitor, or SSRI—was so successful because it got great PR, and because it seemed to have fewer side effects than traditional tricyclic antidepressants. At least it was less likely to cause sedation, dizziness, constipation, or dry mouth. It also was more effective—or at least that was the impression among physicians and patients. There were never any data to support that belief, but that didn’t stop the media blitz. Prozac even made the cover of Newsweek and Time magazines. Once people decided it was the new wonder drug, other pharmaceutical manufacturers were desperate to get in the game. The race was on.
It wasn’t long before the wannabes started showing up, trying to claim a piece of the Prozac pie. Today the competitors include bupropion (Wellbutrin), citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), nefazodone (Serzone), paroxetine (Paxil), sertraline (Zoloft), and venlafaxine (Effexor). Almost 190 million prescriptions are written for these antidepressants each year, with sales exceeding $12 billion.
Such coeds are being prescribed enthusiastically for a wide range of other health problems, too. The pharmaceutical industry has promoted some of these antidepressants for conditions such as obsessive-compulsive disorder, panic attacks, hot flashes, premenstrual distress, nervousness, and shyness (”social anxiety disorder”).
Almost from the beginning, though, these drugs have been controversial. In the original clinical trial for Prozac, 15 percent of patients in the study dropped out because they felt worse instead of better—a statistic that was not widely publicized. Anxiety, insomnia, restlessness, nausea, and tremors caused distress for some people. There also was a high incidence of sexual dysfunction with the SSRIs. But the real controversy has always swirled around whether Prozac and similar compounds could trigger thoughts of suicide or homicide in some people.
Antidepressants and Suicide
In 1988, we received a letter from a grieving physician. His daughter had been prescribed Prozac for an eating disorder; a month later she took her er life by hanging herself. This oph- thalmologist was convinced that Prozac had contributed to her tragic death. At the time, we discounted this story—which we now regret—and told him that depressed people sometimes take desperate action and may try to harm themselves when they start treatment. Later, he responded that his daughter had never been depressed, nor had she been acting like a person who planned to take her life.
In 1990 an article appeared in the American Journal of Psychiatry describing a half-dozen patients who developed “intense violent suicidal preoccupation after 2 to 7 weeks of fluoxetine treatment.” This report stirred up quite a lot of concern, but many psychiatrists downplayed the connection. When we asked the drug company and the FDA about this report, we were told that depressed people sometimes commit suicide and that the drug was not to blame.
Over the last 18 years we have heard of many other instances in which people became preoccupied with harming themselves or others after starting on an antidepressant. A man taking Zoloft awoke in the middle of the night with a strong urge to kill himself. A woman reported wild thoughts on Prozac about ramming her car into other cars and getting a gun to kill an irritating co-worker. Another woman told us that she experienced an overwhelming urge to open her car door and jump-out of the vehicle while it was going at 50 miles an hour down the highway.
My son Mike was prescribed Paxil for depression while he was a graduate teaching assistant at New Mexico State University. Around day 13 he slipped into a mood that I had never seen before. He never came out of it. Four days later he shot himself in the temple with a rifle. He had taken Paxil for 17 days.
I hold the FDA and GlaxoSmithKline (maker of Paxil) responsible for my son’s suicide. No one should ever have to look at a son or daughter’s tombstone!
Whenever we discussed our concerns with psychiatrists, drug companies, or FDA officials, we were told that such events were purely coincidental. Our federal watchdog insisted that the medicines could not have been responsible for such tragic outcomes. But when British drug regulators began warning physicians that SSRI-type medications might trigger suicidal thoughts, agitation, and self-injury in young patients, the whole ball of yarn began to come unraveled.
Eventually, an FDA staffer, Andrew Mosholder, MD, MPH, was given the task of analyzing 22 studies. His conclusion: “Short-term pediatric trials of antidepressant drugs demonstrate an increased rate of suicidal events with active drug compared to placebo.” He also said that there is not adequate information to tell if antidepressants other than Prozac are effective for children.
FDA JULY 1, 2005, PUBLIC HEALTH ADVISORY
• Adults being treated with antidepressant medicines, particularly those being treated for depression, should be watched closely for worsening of depression and for increased suicidal thinking or behavior.
• Close observation of adults may be especially important when antidepressant medications are started for the first time or when doses for the specific drugs prescribed have been changed.
• Adults whose symptoms worsen while being treated with antidepressants, including an increase in suicidal thinking or behavior, should be evaluated by their health-care professional.
The idea that drugs designed to fight depression and prevent suicide could potentially make things worse for some kids seemed to shock FDA officials to the core. Initially, Dr. Mosholder was muzzled. Eventually, though, the data convinced even the FDA hardliners. Belatedly, the agency issued warnings about suicidal thinking and antidepressants. These cautions came far too late to prevent many terrible tragedies over nearly 2 decades. As difficult as it has been for psychiatrists and FDA officials to contemplate, people taking SSRI-type antidepressants are sometimes preoccupied with thoughts of suicide or homicide. Harvard psychiatrist Joseph Glenmullen,’ MD, has criticized the makers of SSRI-type antidepressants for delaying adequate warnings.”‘ The maker of Effexor XR added “homicidal ideation” to its label years after the drug was introduced. The company considers this a very rare adverse event and does not believe the drug can be causally linked to actual homicides. But there have been a number of high-profile violent events associated with antidepressants. Causal or not, this controversy continues to simmer. The entire SSRI-suicide story strikes us as mishandled. Just as with the Vioxx (rofecoxib) scandal, it has seemed to us that FDA officials have been more intent on protecting the pharmaceutical companies’ profits than the public health. To add even more confusion to this already sordid affair, the reputation these drugs have enjoyed as being highly effective against depression is now suspect. Remember that placebo-controlled trials are the gold standard that everyone is supposed to adhere to. Drug companies are required to show that their expensive antidepressants are significantly superior to a placebo. But an “analysis of 96 antidepressant trials between 1979 and 1996 showed that in 52 percent of them, the effect of the antidepressant could not be distinguished from that of placebo. In other words, “more than half of all recent clinical trials of commonly used antidepressants failed to show statistical superiority for the drug over placebo.”
That, dear reader, is almost beyond belief. It suggests that either placebos—sugar pills—are amazingly effective in relieving depression or that current antidepressants are not all that impressive.
Another overview of many clinical trials concludes that the latter is the case. It goes even further and suggests that “recent meta-analyses show selective serotonin reuptake inhibitors have no clinically meaningful advantage over placebo…. Antidepressants have not been convincingly shown to affect the long-term outcome of depression or suicide rates.” Of course, this kind of analysis relies on the statistical manipulation and combining of many smaller studies. As compelling as the conclusions may be, they do not substitute for really big, well-conducted trials.
The largest and most definitive study of depression and antidepressant medications was a $35 million project, funded by the National Institutes of Health, called the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) trial. This was no drug company whitewash. This was your tax money at work. What made this research so valuable was that the investigators looked at actual recovery from depression (”remission”), not just some symptom improvement. Recovery is, after all, what depressed patients really care about. The antidepressants used in the STAR*D trial were bupropion SR (Wellbutrin SR), citalopram (Celexa), sertraline (Zoloft), and venlafaxine XR (Effexor XR). When the long-awaited results were published in the New England Journal of Medicine (March 2006), they were surprisingly disappointing. About one-fourth of the patients achieved real remission, regardless of the type of antidepressant that was taken. What makes this so discouraging is that these patients got optimal treatment. They received intense evaluation and a level of care not usually available to the average patient. If the depressed folks in this study had been treated in a more typical manner, “the remission rate probably would have been significantly lower—perhaps even in the single digits.”That’s abysmal. If there is any good news that came out of the STAR*D research, it is that when a different antidepressant medication was substituted after initial treatment failure, about one in three patients finally did achieve remission. What this means is that antidepressants actually do what they are supposed to do (cure depression) about half the time. Depending upon your perspective, that means the glass is either half full or half empty.
We are happy to learn that 50 percent of the patients in this trial got better. But even under these ideal conditions, half did not, regardless of the type of medicine used. That means that an awful lot of people are suffering drug side effects without benefit. And since there were no placebo controls in STAR*D, we have no idea how many folks might have improved if they had received sugar pills instead of drugs. So how can you determine which antidepressant is best for you? In truth, it is extremely difficult for physicians and patients to make clear decisions about safety and effectiveness when it comes to these medications. Despite all the hype from the drug companies, it is hard to prove that one type of antidepressant is better than another one.
Newer drugs like Cymbalta affect both serotonin and another neurotransmitter called norepinephrine (hence their name serotonin/norepinephrine reuptake inhibitors, or SNRIs). This dual action is supposed to make such drugs more effective. It has certainly driven up the cost. A single Cymbalta pill can cost between $3 and $4. A Wall Street Journal review reported that when Cymbalta was compared head-tohead with venlafaxine (Effexor), an older drug in this class, “Cymbalta wasn’t significantly different from Effexor in treating depression.”
The bottom line is that there are no “best choices” when it comes to these kinds of antidepressants. All these drugs are roughly similar in effectiveness, and all have the potential to cause serious adverse reactions for some people. Anyone who experiences anxiety, agitation, irritability, and especially thoughts of violence toward himself or others should contact a health professional immediately!
Watch Out for Withdrawal!
There is one other complication associated with these antidepressants that is rarely discussed. Sudden discontinuation of drugs like Effexor, Paxil, Serzone, and Zoloft may cause unexpected symptoms. We have heard from many patients that they experienced dizziness, nausea, insomnia, headaches, nervousness, sweating, shakiness (like a bad hangover), weakness, visual disturbances, and an inability to concentrate. One reader called the problem “Paxil Head,” like having your head stuck in a blender.
I take Zoloft, and have tried to stop taking it several times. Each time I stop I experience a-very strange thing. Doctors, nurses, and pharmacists dismiss me like I’m a nut case, but I swear this is true. I get electrical shocklike sensations in my head and become extremely dizzy. I absolutely know this is associated with not taking Zoloft. Not 2 hours after I resume taking it again the symptoms, which are overwhelming, disappear completely. I would like to get off of this drug but have no idea how to do so, especially when I cannot function without it and no one recognizes I’m having any trouble. They just think I’m crazy.
What is so sad about this particular problem is that no one really knows how common withdrawal symptoms are. There are, as far as we can tell, few good guidelines for helping people overcome this complication. So we do not know how long people will experience dizziness, shocklike sensations, or nausea after they stop a drug like Zoloft. Drug companies are not particularly interested in developing protocols for discontinuing SSRI/SNRI-type medications, since they would then need to admit they have a problem on their hands. That means that patients and physicians are on their own. Gradual tapering over several weeks may be necessary. We have heard from some doctors that they switch patients over to fluoxetine and then taper it very slowly. That’s because Prozac lingers in the body and may be less likely to trigger withdrawal symptoms.
Fluoxetine (Prozac)
Fluoxetine is a stand-in for all SSRI-type drugs. Although there are subtle variations between medications in this class, there are more similarities than differences.
Side effects: Headache, nausea, dizziness, diarrhea, nervousness, anxiety, and insomnia are relatively common and may affect up to one-fourth of the patients who take SSRI-type medications. Some people may experience drowsiness or dizziness. Delayed ejaculation, inability to achieve orgasm, and decreased sexual desire are common complications of this entire class of drugs. Less frequent problems may include decreased appetite, indigestion, sweating, mania, dry mouth, heart palpitations, tremor, chills, constipation, blurred vision, memory problems, confusion, rash, and joint pains. Blood sugar control or thyroid function may be altered. Seizures, while uncommon, have been reported in roughly 0.1 to 0.2 percent of patients, an incidence comparable to that seen with older antidepressants. Any thoughts of suicide or violence must be reported to a physician immediately).
Downside: SSRI-type medications like Prozac can interact with many other drugs. Make sure your physician and pharmacist double-check to verify that any other medicine, herb, or dietary supplement you take is safe with your antidepressant.
Cost: Approximately $130 to $140 for a month’s supply of Prozac. Generic fluoxetine costs $16 to $20 for the same amount.
Despite all the controversy, we still think Prozac is worthy of consideration, especially since it is less likely to precipitate withdrawal symptoms when discontinued. And we are not convinced that other SSRI/SNRIs are more effective. Many people benefit dramatically from this or another SSRI or SNRI. Prozac is now available generically as fluoxetine, so the cost factor is less problematic. We’re not convinced, though, that all generic fluoxetine is created equal.
Bupropion (Wellbutrin)
This antidepressant is less likely to interfere with sexuality and may even be helpful for people who have experienced diminished libido. It is also available generically, so there is a cost savings. People tend to feel energized rather than sluggish when taking bupropion.
Side effects: Common complaints include insomnia, dry mouth, anxiety or agitation, headache, nausea, and dizziness. Less common adverse reactions that we are aware of include mania, seizures, irregular heart rhythms, skin rash, hallucinations, paranoia, high blood pressure, and migraine.
Downside: Bupropion can interact with many other medications. Make sure your physician and pharmacist double-check to verify that any other medicine, herb, or dietary supplement you take is safe with your antidepressant. Any thoughts of suicide or violence must be reported to a physician immediately!
Cost: Approximately $130 to $150 for a month’s supply of brand-name Wellbutrin SR; generic bupropion SR runs roughly $60 to $70 for a similar amount.
efit more from one antidepressant than another, this is mostly a process of trial and error. It may take 4 to 6 weeks to begin to see improvement, so it is important to give each medication a fair trial. If no success is achieved after a few drugs in the same class are tried, then it may be time to move on to another category.
Bupropion (Wellbutrin) may offer certain advantages over other SSRI-type drugs. For one thing, it is far less likely to interfere with sexuality. Some have even reported that it restores libido.
Some people do benefit from old-fashioned tricyclic-type antidepressants such as desipramine, imipramine, and nortriptyline. For people who become agitated or anxious on an SSRI/SNRI or find that bupropion keeps them wide awake, tricyclics may offer an acceptable alternative.
There is also a completely different kind of antidepressant that comes as a skin patch (Emsam). We will discuss it at the end of this chapter.
Jul
16
CONSTIPATION. COMPLETE INFORMATION.
July 16, 2009 | Leave a Comment
CONSTIPATION
• Get enough fluid and fiber
• Eat prunes, apples, or apricots
• Sprinkle ground flaxseed on cereal
• Chew sugarless gum
• Use psyllium powder
• Try docusate for less straining
• Use milk of magnesia for quick relief (occasional use)
• Ask your doctor about a prescription for Mira Lax
Many people feel that regularity is the key to good health. Is this true or is it a myth? Grandmothers around the world have promoted daily bowel movements for generations, but there is no evidence that a trip to the bathroom each morning is necessary. People vary in the frequency that suits them best. Some do well on a schedule of no more than three times a week. Others feel good on a schedule as frequent as a few times a day.
Constipation is defined as unsatisfactory defecation, but doctors and patients don’t always agree on what is most important. Physicians may prefer objective measures like the number of days between bowel movements. But people may be as concerned about consistency as frequency. They complain about the effort of passing hard “golf balls” or “bricks.”
Sometimes physicians dismiss constipation as a minor complaint. While it is not usually life threatening, constipation can be serious. Almost 100,000 people are hospitalized each year for constipation-related problems. Many more suffer considerable distress and reduced quality of life as a result of this common condition.
SOME DRUGS THAT MAY LEAD TO CONSTIPATION
• Abilify (aripiprazole)
• Actonel (risedronate)
• Anaprox (naproxen)
• Arimidex (anastrozole)
• Asacol (mesalamine)
• Casodex (bicalutamide)
• Cataflam (diclofenac)
• Catapres (clonidine)
• Cenestin (synthetic conjugated estrogens)
• Clinoril (sulindac)
• Clorpres (clonidine and chlorthalidone)
• Clozaril (clozapine)
• Cognex (tacrine)
• C6rdarone (amiodarone)
• Covers-HS (verapamil)
• Creon (pancreatin)
• Cymbalta (duloxetine)
• Detrol (tolterodine)
• Ditropan XL (oxybutyn n)
• Duragesic (fentanyl►
• EC-Naprosyn (naproxen)
• Effexor (venlafaxine)
• Ferrara (letrozole)
• Geodon (ziprasidone)
• Gleevec (imatinib)
• Imdur (isosorbide mononitrate)
• Kadian (morphine sulfate)
• Kytril (granisetron)
• Lexapro (escitalopram)
• Lotronex (alosetron)
• Lyrics (pregabalin)
• Meridia (sibutramine)
• Mirapex (pramipexole)
• Myfortic (mycophenolic acid)
• Nalfon (fenoprofen)
• Naprosyn (naproxen)
• Orap (pimozide)
• OxyContin (oxycodone)
• Pacerone (amiodarone)
• Pancrease MT (pancrelipase)
• Paxil (paroxetine)
• Permax (pergolide)
• Rapamune (sirolimus)
• Relafen (nabumetone)
• Remeron (mirtazapine)
• Requip (ropinirole)
• Retrovir (zidovudine)
• Risperdal (risperidone)
• Rythmol (propafenone)
• Thalomid (thalidomide)
• Topamax (topiramate)
• Vicodin (hydrocodone and acetaminophen)
• Zofran (ondansetron)
• Zoloft (sertraline)
• Zyprexa (olanzapine)
Fluids and fiber are the cornerstones of constipation prevention. Those who are constipated are often urged to drink more water. Adequate fluid (at least 6 glasses of water a day) is essential, but unless someone is actually dehydrated, drinking extra water does not solve the problem of hard stools.If constipation arises suddenly or if it starts to interfere with everyday activities, it makes sense to check in with your doctor. There are some conditions, such as an underactive thyroid gland or Parkinson’s disease, that can lead to constipation. In those cases the underlying disease needs to be treated.
Warning signs that should trigger a doctor’s visit include blood in the stool or bleeding from the rectum; dark, tarry stool; weight loss of 10 pounds or more; a family history of colon cancer; or a positive Hemoccult test, a way of identifying invisible blood in the stoo1. Be sure to tell the doctor about any of these issues, so the proper workup can be done.
People taking medications or even supplements should also check with their doctor to see whether one of these might be responsible. A surprising number of prescription drugs can trigger constipation as a side effect. Because of the impact that constipation can have on their sense of well-being, patients sometimes become upset if doctors don’t warn them that a prescribed medication may interfere with bowel function. Narcotics are among the most notorious offenders, but there are many others. Sometimes, switching to a different medicine can ease the problem. The physician should always be involved in such a decision, because some of these drugs may be essential treatment for a serious condition such as cancer or AIDS.
Dietary Approaches
For uncomplicated constipation, focus on increasing the high-fiber foods in the diet. Sometimes, people buy a loaf of softand-squishy “wheat” bread and figure that’s all they need to do to get extra fiber. Wrong! Unfortunately, the “wheat” label may just be a marketing ploy. Consumers need to read the ingredient list to see if the first ingredient is whole-wheat flour. That’s a good start.
Even better is to actually consume the whole grains in pilafs or porridges, which is one reason we are so fond of steel-cut oats. (Also, they taste wonderful.) One of our favorite high-fiber breakfasts is steel-cut oats with extras: blackberries or pieces of apple, together with walnuts or almonds, topped with a sprinkling of freshly ground flaxseed. To boost the protein content of this breakfast, we stir in some egg white while the oats are cooking.
FOODS THAT ARE HIGH IN FIBER
• Apples 0 Lima beans
• Barley 0 Oat bran
• Beans 0 Oats (steel-cut)
• Blackberries 0 Pears
• Bran a Popcorn
• Bran cereal 0 Prunes
• Broccoli 0 Raisins
• Bulgur wheat 0 Split peas
• Chickpeas 0 Uncle Sam Cereal
• Fiber One cereal 6 Wheat berries
• Figs • Winter squash
• Lentils
Q. My wife is bedridden with emphysema and osteoporosis. Her fractured vertebrae are due to the steroids she takes for emphysema.
The doctor suggested calcium to strengthen her brittle bones. Then she had a problem with bowel movements because of not getting any exercise.
This caused her great distress until she tried eating a quarter of an apple every evening. The apple has made her regular again.
A. Thanks so much for reminding us all of the importance of fiber in the diet. This may help explain the wis-dom behind Grandmother’s recommendation of an apple a day.
Prunes
Why are the marketers changing the name of prunes to “dried plums”? While it is an accurate designation, it’s not particularly catchy. Instead, it is an attempt to get away from the image of self-treatment for constipation that “prune” or “prune juice” conjures up.
Q. A year ago I had a serious problem with constipation (over 2 weeks!). I tried everything I could, including Metamucil, Ex-Lax, milk of magnesia, and a Fleet enema with no results. A visit to the doctor resulted in a prescription but still no relief. Then I remembered. Prunes are laxatives. I bought some prune juice with pulp and drank 4 ounces a day with plenty of water. Within a few days I was back to normal. For a few months I drank some every other morning to keep me regular. Now I only need it once a week. Prune juice with pulp is my salvation.
A. Prunes are a time-honored home remedy for constipation. Researchers have confirmed what grandmothers always knew: Prunes stimulate the digestive tract.
In 1951 scientists discovered an ingredient in prunes that is closely related to the chemical laxative oxyphenisatin. This product was taken off the market when it was linked to liver damage.
Experts for the Harvard Health Letter suggest, “it is unlikely that moderate consumption [of prune juice] would cause any problems, but prune use, like everything else, should be prudent.”
Prunes are said to be loaded with antioxidant phytonutrients, so they are a healthy choice if consumed in moderation. They are not the only dried fruit that can be helpful in an attempt to overcome constipation. Dried figs and even apricots provide a little variety. They may not have any specifically laxative components, but they certainly are good sources of fiber, and some people find them quite helpful. Dried apricots (two a day) and plenty of water can relieve constipation. It helps me and has helped my friends.
Flaxseed
Another source of fiber is not nearly as well known as prunes. Flaxseed has long been used as a source of soluble fiber. It is one of the ingredients in an old-fashioned cold cereal, Uncle Sam Cereal. Once marketed as a “natural laxative,” it is now being touted as a low-glycemic-index or low-carb food. The primary ingredients are wheat berries and flaxseed. Both should help to keep things moving in the right direction.
Constipation has been my problem for more years than I want to count Psyllium seed barely works.
My solution is flaxseeds ground in my coffee grinder I keep it in small batches in the refrigerator and take’/ teaspoon with a glass of juice or water daily. Sometimes I sprinkle it on my cereal or put it in a fruit smoothie. I like the nutty taste and it has been like a miracle for me.
Ground flaxseed is a good source of soluble. fiber. Not only is it helpful against constipation, it can aid in lowering cholesterol and may help reduce the hot flashes of menopause. Flaxseed is an excellent plant source of omega-3 fatty acids.
Downside: Keeps well until ground, then is susceptible to going rancid. Keep ground flaxseed in the refrigerator for no more than 10 days to 2 weeks.
Cost: Approximately $4 to $5 per month (around 130 a dose).
Besides combating constipation, flaxseed is an excellent source of omega-3 fatty acids and has the added advantage of lowering cholesterol at least modestly. The seeds keep well, but once they are ground (a blender or a coffee grinder works well), they go rancid quickly. Ground flaxseed meal should be kept in the refrigerator or even in the freezer. Someone with a tendency to constipation might well want to get in the habit of incorporating ground flaxseed into meals.
Another way to get the benefits of flax is to make a solution. Simmer 2 tablespoons of flaxseed in 3 quarts of water for 15 minutes. Cool the liquid and strain it. It should be kept in the refrigerator. Add 2 ounces a day to fruit juice.
Sugarless Gum
It might be surprising to learn that something as simple and inexpensive as sugarless gum could counter constipation quite effectively. By the way, the converse is also true. People sometimes have problems with chronic diarrhea because of their gum-chewing habits. Sugarless candy has the same impact. Pick a flavor that you like and experiment to find the right dose. The “sugar alcohols” used to sweeten sugarless gummaltitol, sorbitol, mannitol, and xylitol—are not absorbed from the digestive tract. They act as “osmotic laxatives.” Chewing sugarless gum does not contribute to tooth decay. A gum containing xylitol might even help fight ear infections.
Side effect: Diarrhea
Downside: Many sugarless gums contain aspartame, which some people prefer to avoid.
Cost: Approximately 70 to 150 a dose
Q. I read with interest and sympathy a letter about problems with constipation. I wanted to share something that has helped me. After hearing some people complain that sugar-free jelly beans gave them diarrhea if eaten in quantity. I decided to see if they would help my frequent constipation. I have found that if I eat 30 sugar-free jelly beans with a glass of water half an hour before bedtime, I stay regular. I hope this idea might help others with the same problem.
A. Thanks for the tip. Many people find that the sweeteners in sugar-free candy can cause diarrhea. How clever of you to turn that side effect to your advantage! Each person will have to experiment to find the right “dose.”
Over-the-Counter Remedies
Laxatives are among the most popular products in the pharmacy. Hundreds of millions of dollars are spent each year on these over-the-counter remedies. But overuse of such products can be a serious problem.
Q. My 19-year-old daughter and her girlfriend have been taking laxatives for weight control for several months. They also take over-the-counter diet pills.
My main concern is about the abuse of laxatives. Would you please print the harmful effects laxatives can cause? She won’t listen to me!
A. Chronic laxative abuse can undermine the body’s ability to eliminate waste on its own. We have heard from many elderly people who started using laxatives in their youth and became dependent upon them.
We are more concerned, however, about the potential interactions these young women might experience. Strong laxatives can deplete the body of potassium.
Laxatives are not an effective tool for lasting weight loss. Dietary counseling and exercise may be more helpful in the long run.
We generally suggest that people avoid stimulant chemicals like aloe, cascara sagrada, senna, and castor oil. These can be irritating to the digestive tract. Some of these compounds can interfere with proper nutrition, and chronic use might make a person more susceptible to weakened bones.
Bulk-Forming Laxatives
The first step in treating constipation is to increase your intake of fiber. Since dietary fiber may not be enough, there are several possible sources of fiber sold as “bulking agents” in the pharmacy. Psyllium is a naturally derived fiber from blond ispaghula seed (Plantago ovata). It can usually be bought quite inexpensively. There are also some alternative types of fiber.
Adequate fluid intake is crucial when taking fiber. Swallowing fiber such as psyllium without enough water could lead to choking as a result of the product clumping and swelling in the esophagus. Other digestive tract blockage is also possible if fluid intake is inadequate.
If psyllium is not satisfactory, other possible fiber sources are available. Polycarbophil (Equalactin, FiberCon, Fiber-Lax, Konsyl Fiber) may be the next step.
Sold under a number of brand names, including Metamucil, Fiberall, Konsyl, Perdiem Fiber Therapy, Reguloid, and Serutan. Store brands, available in most drugstore chains, are more economical. Psyllium (I tablespoon in 8 ounces of water three times a day) is approved both for constipation and for lowering. cholesterol. It may take a few days to observe the effects. Psyllium is considered safe for daily use. Sugar-free brands may be more economical, but most contain aspartame, which some people would rather avoid. No bulk-forming laxative should be taken if the person is nauseated, vomiting, running a fever, or suffering abdominal pain. Such symptoms deserve prompt medical attention.
I’ve had such frustration with constipation over the years. I’ve tried a lot of remedies, but the ones that worked were too harsh. Then a friend told me about UniFiber. It is a very fine powder, and I combine it with canned peaches or homemade oat bran muffins. It really regulates my system with no diarrhea or cramping.
Stool Softeners
When the main problem is that the stool is hard, the best remedy may be a stool softener. These are also recommended for people who have had abdominal or colorectal surgery or an episiotomy during labor and delivery and must avoid straining.
Old-fashioned mineral oil is the best-known product in this category. It should be used for only a short time, though. Mineral oil is petroleum-based and is not absorbed into the body. But it can interfere with the absorption of important fat-soluble nutrients, such as vitamin A, vitamin D, vitamin E, and vitamin K. Over weeks or months, this could be detrimental to health.
The doctors’ choice in stool softeners is usually docusate sodium or docusate calcium. Although the evidence of their effectiveness is not strong, 118 they are widely used. They might work better in a postsurgical situation than they do for chronic constipation.
Dacusate Sodium
Available as Colace and Ex-Lax Stool Softener, and generically under various store brand names. Acts as a wetting agent to help stool absorb more water and thus become softer. Expect this product to take up to 3 or 4 days to work.
Side effects: Rash, throat irritation, nausea Cost: Approximately 250 to 500 per dose
This usually works fairly rapidly, within several hours. Each dose should be taken with 8 ounces of water. It is intended for occasional use only.
Side effects: Diarrhea, nausea, weakness
Downside: This laxative contains magnesium, so it should not be used by people with kidney disease. It may disrupt the balance of minerals and fluid in the body.
Cost: Approximately 600 to 750 per dose
Osmotic Laxatives
Compounds that attract water into the digestive tract add moisture to the stool. This softens it and may even help hurry it along. Such agents are called osmotic laxatives. We’ve already discussed sugarless gum, which works in this manner. It also exemplifies the downside of these laxatives: Getting the balance just right can be difficult. It’s not rare for a person to experience diarrhea as a side effect if the dose is too high. Some old familiar remedies fall into this category. Both Epsom salts and milk of magnesia are osmotic laxatives.
Prescription Laxatives
Chronic constipation can be extremely frustrating. If lifestyle changes and over-the-counter approaches are unsuccessful, people turn to their doctors hoping for a miracle. In this situation, miracles are few and far between. Physicians do have a few drugs they can prescribe that may be helpful. One is a type of osmotic laxative called lactulose (Chronulac, Duphalac, Kristalose) that has been around quite a long time. This is a type of sugar that is not absorbed well, so it pulls water into the intestines. It may take a day or 2 to produce results, and it can result in cramping, gas, or diarrhea.
There is another option as well. A prescription laxative containing polyethylene glycol, an ingredient quite similar to those used for cleansing the colon prior to a colonoscopy, can be used for desperate cases. MiraLax is not supposed to be used for more than 2 weeks at a time, however. MiraLax is an osmotic laxative.
The doctors’ big gun in prescription products is Zelnorm
Contains polyethylene glycol, or PEG. It comes as a powder to be dissolved in juice, water, coffee, or tea. Expect results in 2 to 4 days. Do not use for more than 2 weeks.
Side effects: Diarrhea, abdominal cramping, nausea, gas Downside: Prolonged or excessive use may upset the balance of fluids * and minerals in the body or result in laxative dependence.
Cost: Approximately $1.40 to $2 per dose; one dose per day
(tegaserod). It was developed for people who have irritable bowel syndrome with h constipation as the predominant symp- tom. It has also been approved for chronic constipation in adults under the age of 65. Your doctor will be able to evaluate if this last resort is appropriate for you. There have been instances of serious, dehydrating diarrhea that required hospitalization. Another dangerous side effect that worries us is ischemic colitis, a condition in which blood supply to part of the intestine shuts down. It has not been established whether Zelnorm was responsible for this frightening complication. Nevertheless, this drug is probably appropriate only when everything else has failed.
10 Tips for Combating Constipation
1. Pay attention to your diet. Getting plenty of fiber and fluid is essential. In addition, though, some foods tend to be constipating. Cheese has a reputation in this regard, but coconut, which can help ease diarrhea, may be constipating if too much is eaten. Other people have warned of the effects of pomegranate, mango, or peanut butter. The tannins in tea may also contribute to constipation.
2. Sip warm water with a tablespoon of blackstrap molasses. This sweetener contains a number of minerals. Some people find it a tasty way to cope with constipation. Another old-fashioned home remedy for constipation is drinking lemon juice in a cup of hot water first thing in the morning. Afterward, rinse your mouth with plain water, to protect your teeth.
3. Simmer 2 tablespoons of flaxseed in 3 quarts of water for 15 minutes. Cool, strain, and add 2 ounces of the liquid to orange juice every day. An alternative is to use freshly ground flaxseed on cereal or other foods.
4. Chew sugar-free gum. Experiment to find the appropriate dose. Or, if you prefer, eat sugar-free candy. Either may ease constipation; don’t overdo it.
5. Take psyllium powder in 8 ounces of water. For when you’re traveling, Metamucil makes psyllium cookies that are easier to carry, but they’re also more expensive and higher in calories.
6. Stay away from traditional laxative herbs such as aloe, cascara sagrada, and senna. They are harsh and overstimulate the digestive tract. Very occasional use may be acceptable, but overuse can lead to dependence. Instead, try dong quaff, ginger, or milk thistle.
7. Load up on vitamin C. Some people find that about 2,000 milligrams a day is enough to trigger diarrhea. Finding the dose that works for you and backing off just slightly is one approach that may work. Do not try this if you have ever had kidney stones, because excess vitamin C raises oxalate excretion and might increase the risk of a recurrence.159
8. Stir a couple teaspoons of Swedish bitters into a cup of water. Hot water or herb tea may work best. It also comes in capsules that are convenient when traveling.
9. Experiment with a bulk-forming laxative. Some people find that UniFiber or Citrucel works better for them than psyllium.
10. Make sure you get enough magnesium, especially if you are taking calcium supplements. Calcium carbonate can be constipating, but magnesium can help offset this tendency. We generally advise people that a dose above 300 milligrams of magnesium per day may cause diarrhea. The maximum short-term dose of magnesium advised on the label of Phillips’ Milk of Magnesia is 2,000 milligrams for adults. Do not take magnesium or milk of magnesia if you have kidney disease.
Conclusions
Constipation accompanied by pain, nausea, vomiting, or fever should not be ignored. It deserves medical attention. Even without such symptoms, persistent constipation should also be brought to a physician’s attention. Uncomplicated constipation may respond to home treatment.
• Begin with diet. Make sure you get six to eight 8-ounce glasses of water or other fluids daily. Concentrate on increasing fiber, and make sure you get 25 to 35 grams daily.
• Ask your doctor to check whether a medical condition or medication may be causing your constipation.
• Eat fruit. Apples, dried apricots, and (in moderation) dried plums, aka prunes, are a wonderful way to establish regularity when needed.
• Sprinkle ground flaxseed on your food, or take a solution of simmered flaxseed in juice.
• Chew sugarless gum or enjoy sugar-free candy for its laxative effect.
• Take psyllium as directed, with an 8-ounce glass of water.
• Docusate may soften stools and ease straining.
• Milk of magnesia may give relatively quick relief, but should not be overused. It’s off-limits for anyone with kidney trouble.
• Drugs such as MiraLax are intended for short-term use of less than 2 weeks.
Jul
15
Living with your Prostate. FAQ.
July 15, 2009 | Leave a Comment
Living with your Prostate
We hope we have shown you two things: firstly, you need to be aware of your prostate gland and what can go wrong with it, so that you can get treatment for any possible problems if they arise; and secondly, even if problems do arise, they are unlikely to be as bad as you may fear, and can probably be completely cured.
BE AWARE AND DON`T DESPAIR are the key words when it comes to the prostate. A positive outlook on life is one of the greatest weapons we have at our disposal. Never forget it.
BE AWARE
It is important to keep an eye on any changes in your urinary habits, particularly after the age of 50. Changes may creep up on you slowly over the years, but don’t use that as an excuse for not taking them seriously.
Ask yourself the following questions:
• Do you have to get up at night to urinate?
• Do you urinate much more often than you used to?
• Do you have difficulty passing water?
• Is your flow of urine particularly thin or weak, particularly in the morning’?
• Do you ever experience any pain when you urinate?
• Do you ever notice any blood in your urine?
• Can you urinate as high, or as far, as you used to’?
• Do you get pains in the region of your prostate, in the groin, or around your genitals?
• Do you sometimes find it difficult to start the flow of urine’?
• Do you sometimes find that you involuntarily stop and start urinating?
• Do you sometimes feel as though you haven’t quite emptied your bladder and there’s more to come?
• Do you have to strain to pass water?
• Do you ever suffer from incontinence?
• Does your urine continue dribbling, even when you think you’ve finished’?
• Do you sometimes need to rush urgently to the toilet to urinate?
• Do you ever notice blood in your semen?
Warning symptoms
If you have answered Yes to one (or more) of these questions, you may be experiencing problems with your prostate. Warning signs of this kind are there to be taken notice of and you should never ignore them. Men are notoriously good at sweeping under the carpet things that make them feel uncomfortable, and signs that all may not be quite as they should be on the health front come into this category. The reason why you should not do this is a straightforward, not to say obvious, one. It is, quite simply, because the sooner you do something about them, the greater your chances of doing something constructive about them and effecting a cure.
Men also tend to be frightened of wasting their doctor’s time and being viewed as a nuisance. But you shouldn’t worry about this, your doctor is very unlikely to think this way. Doctors are there to look after your health, and if something is really worrying you that’s enough to warrant a visit. So the message is:
GO TO SEE YOUR DOCTOR
CONSULTING YOUR DOCTOR
First of all, your doctor will want to know all your symptoms. To make sure you don’t forget to tell him about any of these, make a list of them before you go to the surgery. You should also make a note of any questions you want to ask him. The doctor will take a general medical history, with particular reference to any serious familial diseases such as diabetes, heart disease or haemophilia, and any drugs you are taking. He will also want to know about any important changes in your health that you have noticed recently, such as general fatigue or lower back pain, which may not seem to you to be at all relevant but which could be important to the doctor. If you’re worried about your urinary habits, it’s as well to establish a relationship with your doctor, so you can get to know him and he can get to know you and your anxieties sting. If you’re just starting to have symptoms, he may not find anything much wrong now, but he will want you both to keep an eye on things and to monitor the situation. Above all, never be embarrassed to talk to your doctor about your urinary habits. He won’t be embarrassed and you shouldn’t be either.
YOUR LIFESTYLE
There are several changes you can make to your lifestyle which will help keep your prostate healthy.
Try to do the following:
• Don’t smoke. Smoking causes spasm in smooth muscle and may, as a result, make matters worse, particularly if a prostate problem has already been diagnosed.
• Keep your consumption of alcohol, which can irritate the bladder, as low as possible. In particular, avoid beer.
• Avoid coffee nexium swollen lip problems . Coffee has an irritating effect on the bladder at the best of times, and if the bladder is already
`unstable’, this effect is likely to be heightened.
• Try to keep stress in your life to a minimum, as it can intensify urinary problems such as hesitancy and urgency.
This is easier said than done, but you may benefit (wouldn’t we all?) from making every effort not to allow yourself to be too easily worked up by the pressures of modern-day life. Try learning some relaxation techniques.
• Try to avoid going out in the cold, which can often trigger bladder problems.
• Wrap up warm.
• Get plenty of sleep.
• Take regular exercise. In particular, it is thought that having played a lot of sport regularly as a child, particularly before reaching puberty, may have a protective effect against the development of cancer of the prostate. Exercise is still beneficial in adult life because it keeps the muscles around the abdomen active.
• Don’t regularly restrict your fluid intake because you are frightened of having to go to the loo too often. Drinking less may not actually help anyway. If you have an important meeting, or are going to the theatre, restrict your fluid intake from about three hours beforehand, which should help make it easier for you to go out. You can also restrict fluid intake at night, which may mean you don’t have to get up so often to urinate.
Jul
15
Prostatitis. DIAGNOSIS OF PROSTATITIS. CHRONIC PROSTATITIS. ACUTE BACTERIAL INFECTION.
July 15, 2009 | Leave a Comment
Prostatitis. DIAGNOSIS OF PROSTATITIS. CHRONIC PROSTATITIS. ACUTE BACTERIAL INFECTION.
Prostatitis is a catch-all expression covering various types of inflammation of the prostate. It is not as serious as enlargement of the prostate, and especially not as serious as cancer of the prostate. It can, however, be a very difficult condition to treat and can sometimes drag on for several years. In prostatitis, the tiny glands in the prostate become infected, inflamed or clogged - either with thickened secretions or with small gravel-like stones. As we have seen in Chapter 1, the prostate is a complex system of glands, cells, tubules and ducts. Once infection gets a hold in this complicated network, it is hardly surprising that it can be very difficult to eradicate.
Even when it has been treated - and even when it seems as though it has been successfully treated - it can still come back. And in the absence of successful treatment, it can flare up for years, with depressing regularity.
THREE TYPES OF PROSTATITIS
There are three main types of prostatitis. These are:
• Acute bacterial infection.
• Chronic infection, which may be bacterial or non-bacterial.
• Prostatodynia, which may cause the symptoms of prostate pain without any obvious signs of inflammation or infection.
DIAGNOSIS OF PROSTATITIS
Prostatitis is sometimes difficult to diagnose. In general, the person best qualified to diagnose prostatitis is a doctor specialising in urology or genito-urinary medicine clinical trials. Your doctor may refer you to a special genito-urinary (GU) clinic. This does not mean that your doctor suspects that you are suffering from a sexually-transmitted disease. It simply means that genitourinary clinics have the best experience and equipment to investigate and treat your symptoms. The staff are used to dealing with this kind of problem, and will do so sympathetically and in confidence, so you have no need to feel embarrassed. You are likely to have a number of tests as part of the investigation of your symptoms. These may include some, or all, of the following:
• A digital rectal examination, which means that the doctor inserts a lubricated gloved finger into the rectum and gently palpates, or feels, the prostate through the front wall of the rectum, which lies against the back of the gland. If you have prostatitis, the prostate will feel boggy, soft and tender. A digital rectal examination should not hurt,
though it may be uncomfortable if the prostate is inflamed and therefore tender to the touch. A lot of men are embarrassed to have one, but they shouldn’t be: doctors are used to doing this and have a very matter-of-fact attitude to it.
• Swabs from the end of the penis, which are taken by gently inserting a sterile cotton bud into the end of the penis and taking any fresh discharge.
* Urine tests to check for cloudiness, signs of protein or blood, and threads of cellular niaterial, which are then examined under the microscope for pus cells or bacteria.
® Urine cultures to see if any bacteria grow, which should also distinguish between infection in different parts of the urinary tract.
• A blood test to check for a raised white cell count.
• Routine screening for sexually-transmitted diseases such as chlamyclia.
• The doctor will look for a discharge from the penis, and for signs of inflammation and soreness both on the penis and in the testicles. If prostatitis is untreated, or it’ drug treatment is unsuccessful, there is a risk that the prostate gland may become full of pus 5 online sildenafil citrate . Not surprisingly, this can have dreadful consequences. It may eventually burst, releasing pus into the urethra, which will discharge from the tip of the penis. And it may also result in severe infection elsewhere in the urinary tract.
ACUTE BACTERIAL INFECTION
This is an uncommon complaint. It is usually caused by bacteria from the intestines. These find their way into the urinary system, either through the urethra or through the bloodstream or lymphatic fluids.
Sometimes there is a link with organisms that cause a sexually-transmitted disease, such as gonorrhoea or chlarnydia. Sometimes, too, the fungus that causes thrush (Candida) is responsible.
Symptoms
These can happen suddenly and can include one or several of the following:
• Feeling generally under the weather.
• Chills or fever.
• An aching feeling around the thighs and genitals.
• A deep pain in the perineurn, which is the area between the pouch containing the testicles, known as the scrotum, and the anus.
• Low back pain.
• Pain in the lower abdomen.
• Pain on passing water.
• Blood in the urine.
• Difficulty in passing water.
• Increased frequency of passing water.
• Urine may be cloudy or smelly.
• Pain on ejaculation.
Diagnosis
The doctor will probably perform a digital rectal examination by inserting a lubricated gloved finger into the rectum. He will then feel the prostate through the wall of the rectum. If a man has prostatitis, the prostate will probably feel hot, swollen and tender. The doctor will then do a series of tests on a sample of urine and On urethral secretions obtained after massaging the prostate gland, in order to investigate the cause of the infection.
Treatment
Acute bacterial prostatitis, when symptoms come on suddenly, is the most dramatic form of the disease, but it is also the form that responds best to treatment. A prolonged course of antibiotic tablets is prescribed. This is usually for at least four weeks. Acute infection responds well to antibiotics, probably because the intense inflammation allows the drugs to penetrate into the interior of the gland. Symptoms should begin to show some improvement within the first few days. Sometimes, though, infection may persist in the prostate, in spite of treatment, and it is necessary to have careful follow-up treatment to make sure that the condition has cleared up. If this does not happen, the condition may tend to recur and chronic prostatitis will usually result. Occasionally, though rarely, infection may cause the gland to swell sufficiently for the urethra to be squeezed shut. This causes urinary outflow obstruction . It necessitates urgent admission to hospital, where urinary flow is eased by inserting a catheter directly into the bladder. With rest and the administration of antibiotics, the infection will usually clear up well in only a few days.
CHRONIC PROSTATITIS
Chronic prostatitis is more common than acute prostatitis, but is much more difficult to eradicate. There are two types of chronic prostatitis, which can be bacterial or non-bacterial. Chronic bacterial prostatitis Swelling occurs rapidly and this traps the bacteria in the gland, as the usual drainage channels become blocked. Prostatic secretions may coat the offending bacteria, which then harden to form tiny stones, or crystals. This protects them from being attacked by the body’s immune system or by antibiotics. This explains the repeated flare-ups that tend to occur in chronic bacterial prostatitis. This means, too, that the condition can be difficult to treat successfully. Some sufferers may even be unlucky enough to suffer from recurrent symptoms throughout their lives.
Symptoms
These vary from one person to another. They may include any, or several, of the following:
• Frequency in passing water.
• Pain on passing water.
• Pain in the prostate, genitals or rectum.
• Swelling of the testes.
• Lower back pain.
• Watery discharge from the penis.
• Pain on ejaculation.
• Blood in the semen.
• Premature ejaculation.
• If the doctor feels the prostate during a digital rectal examination, it may feel boggy, soft and squelchy.
Fertility
There is some evidence that chronic bacterial prostatitis may impair. This may probably be true in all cases of prostatitis, but seems to be especially true of chronic bacterial prostatitis. Analysis of the prostatic fluid of men with chronic bacterial prostatitis has shown significant changes in both the physical properties and the chemical constituents of the fluid. It is thought that these changes may well affect the quality of the semen, and thus the level of fertility. It is not unusual for doctors to hear the wives of men with chronic bacterial prostatitis complain that they are finding it difficult to become pregnant. A sperm count and sperm quality assessment can be done to find out how much a man’s fertility has been affected.
Chronic non-bacterial prostatitis
This is a complaint in which inflammation is present without any signs of infection. In other words, prostate secretions contain white pus cells, but no bacteria. It is not known exactly what causes chronic non-bacterial prostatitis, but several theories have been suggested. One is that it is caused by abnormal emptying of the bladder, which forces urine into the prostate channels and ducts, where it causes irritation and inflammation. This may be triggered, or aggravated, if a man jogs or plays any strenuous sport on a
full bladder. Another theory is that some men produce thicker prostate secretions, which are perhaps more acid then normal. These secretions are unable to drain away through the narrow ducts and therefore build up to cause irritation and swelling.
Symptoms
The most common symptoms of chronic non-bacterial prostatitis are:
• Frequency in passing water.
• Pain on passing water.
• Pain or ache in the prostate, genitals or rectum.
• Lower back pain, especially after sexual intercourse.
• Discharge from the urethra, especially after intercourse.
Treatment
Any chronic infection is difficult to treat, particularly when inflammation and swellings trap the infection inside the gland. In the case of chronic bacterial prostatitis, a course of the appropriate antibiotic, depending on which bacterium is responsible for the condition, will be prescribed for at least six weeks. Sometimes antibiotics may be required for as long as three months, or even longer. Chronic non-bacterial prostatitis can be treated with a natural food supplement derived from rye pollen extracts, which
has been shown to reduce inflammation, irritation and swelling, though improvement may not be apparent for at least three months and full recovery may take as long as six months or even more. Swelling, inflammation and pain may be helped by anti-inflammatory painkillers such as ibuprofen.
Self-help
Chronic non-bacterial prostatitis is sometimes relieved by an increased frequency of ejaculation. This can be brought about through intercourse, of course, but if this does not happen it may equally be brought about by masturbation. Ejaculation drains the prostate of any excess secretions and causes a temporary increase in blood. Both these things help to flush away any toxins. In some cases, however, an increased frequency of ejaculation only makes the problem worse.
PROSTATODYNIA
This is characterised by the usual symptoms of prostate problems, including pain, but with no evidence of inflammation or infection in the gland. Prostate secretions look perfectly normal and contain no pus cells. Prostatodynia is surprisingly common and accounts for around one third of all cases where men experience the symptoms of chronic prostatitis.
Symptoms
The symptoms of prostatodynia are therefore similar to those of chronic prostatitis. They may often also include psychosexual problems.
Symptoms include the following:
• Frequency in passing water, sometimes with associated pain.
• Pain in the prostate, genitals or rectum.
• Lower back pain.
• Watery discharge from the penis.
• Blood in the semen (haemospermia).
• Premature ejaculation.
• Pain on erection.
• Pain on ejaculation.
• Low sex drive.
• A diminished volume of semen.
• Impotence.
• If the doctor feels the prostate during a digital rectal examination, it may feel boggy, soft and squelchy.
Treatment
Prostatodynia can be difficult to treat. Painkillers are not usually helpful. It is, however, likely to have a physical cause, such as spasm of the pelvic muscles, which may be brought on by stress and anxiety. In this case, tranquillisers may be prescribed in order to reduce muscular spasm in the gland, though it is not a good idea to take these in the long-term as they can become addictive. Recent studies have suggested that prostate pain can be relieved by microwave hyperthermia. The technique was originally developed at the Beilinson Medical Centre, Petah Tiqva, in Israel in the early 1980s and is now attracting a lot of interest in other countries. An hour’s treatment is usually given weekly for six weeks.
Other treatments that have been tried for prostatodynia include:
• Acupuncture.
• Laser irradiation.
• Muscle-relaxant drugs, such as diazepam.
• Antispasmodic drugs.
Self-help
As in chronic non-bacterial prostatitis, symptoms may be worsened when ejaculation is infrequent, in which case the pain may be caused by prostatic gland engorgement. Symptoms may therefore be relieved by an increased frequency of ejaculation, as a result of either intercourse or masturbation. Ejaculation drains the prostate of any excess secretions
and causes a temporary increase in blood supply. In some cases, however, an increased frequency of ejaculation only makes the problem worse. Sitting in a hot bath for half an hour can help to warm up the prostate gland. Relaxation techniques may also be used to relax the muscles and as an alternative to muscle-relaxant drugs. The combination of regular exercise and a high-fibre diet will help keep the bowels regular, which is particularly important for men suffering from prostatodynia. This is of special benefit to those men who sit at a desk for most of the day, as both constant sitting and constipation tend to increase prostate congestion. Symptoms of prostatodynia may be triggered by the nicotine in cigarettes and by alcohol or caffeine, so it is best to reduce consumption of all three. It may also be advisable to consult an allergy specialist who may be able to identify foods that you should avoid.
Natural treatments
Rye pollen extracts have been shown in clinical trials in Europe to help ease the symptoms of prostatitis, particularly chronic non-bacterial prostatitis and prostatodynia. They reduce inflammation and ease irritation. They may take as long as three months before they show any improvement, which may then continue over the next three months. Rye pollen
extracts, such as Cernilton and ProstaBrit, are available from health food stores.
Jul
15
The Prostate in Sexual Activity.
July 15, 2009 | Leave a Comment
The Prostate in Sexual Activity
The prostate is part of the male reproductive system and supplies part of the seminal fluid. It is not essential for the man’s sexuality, though, nor even for his ability to reproduce. When a man’s prostate is removed, male sexuality is not normally affected ripped fuel. His sex drive is intact, and his ability to
achieve and maintain an erection is unchanged.
SEMINAL FLUID
In fact most of the fluid you ejaculate isn’t sperm at all. Most of the fluid consists mainly of secretions from a number of glands. The largest of these glands is the prostate.
The various secretions from these glands probably serve the purpose of providing the sperm with a greater motility after they have been ejaculated, which stimulates their activity and enables them to move towards the egg. It is thought by some people that the prostate also has a lot to do with the feeling that an orgasm gives you. When a man
has an orgasm, sperm fluid from the seminal vesicles and the secretions from the prostate all mix together as semen at the top of the urethra, just below the bladder. A man gets an intensely pleasurable sensation when the semen floods down the urethra into the penis . He also gets a pleasurable feeling when the semen squirts out of the penis and into the tight region of a woman’s vagina. The prostate gland can be felt, as a man’s orgasm proceeds, to contract i-liythmically, which some people believe to be very much an integral part of the pleasure he experiences on orgasm.
What prostate fluid contains:
• Water.
• Salts.
• Minerals.
• Proteins.
• Antibodies.
• Enzymes.
• Citric acid.
• Fats buy domain fioricet tramadol .
• Prostaglandins, which are hormone-like chemicals.
PROSTATIC DISEASE
Prostatic disease can have an effect not only on the urinary system, but also on the reproductive system. The male reproductive and urinary systems are, of course, closely linked, if only because they share the same exit route - the penis - or, to be more exact, the urethra which runs through the centre of the penis. The prostate gland is the site at which the male sex hormone testosterone, which is made by the testicles, is broken down. It is here that it then forms another hormone called dihydrotestosterone (DHT). The conversion is controlled by an enzyme called 5-alphareductase. In a study conducted by Imperato-McGinley (Science, 1974), the males in an obscure tribe in the Dominican Republic are deficient in 5-alpha-reductase and are often mistaken for girls until they reach puberty. Until then, they have a very small penis and scrotum, which suddenly enlarge at puberty, along with the development of a deep voice. These males only ever develop a very small prostate gland, they never go bald, and they do not suffer from acne check.
It is this genetic deficiency in 5-alpha-reductase that has enabled researchers to comprehend the role played by dihydrotestosterone in the enlargement of the prostate gland.
Testosterone
As well as prostate enlargement, the male hormone testosterone also has several other effects on the male body.
These include the following:
• The growth of the penis.
• The growth of testes.
• The production of sperm.
• A deeper voice.
• The growth of facial and body hair.
• The male sex drive.
• Bone growth hair loss.
• Strength.
• Acne.
• Baldness.
A MAN’S GREATEST FEARS
One of man’s greatest fears on seeing a urologist and considering the prospect of a prostatectomy is what effect this will have on his sexuality. The idea of having any sexual organ tampered with by a surgeon is very frightening for most men, who worry that it may have a deleterious effect on their sex lives. Many men are so frightened that their prostate problems will affect their sex lives, particularly if they have to have an operation, that they put off going to the doctor gastroparesis caused by prozac . And even when they do eventually go to the doctor, they may be too embarrassed to discuss sexual matters. Sex is something that all too many men find difficult -if not impossible - to talk about with their doctor. But this is foolish. It is only by talking the matter over with their doctor that they will find their fears were groundless and that they can therefore be reassured.
The doctor’s role.
To make matters worse, some doctors and urologists are sometimes insensitive on this subject. It is quite wrong of them to assume that their patients are too old to be interested in sex. Sex can play an important role in the lives of many men until well into old age, and they should treat their fears as real and serious. A man who is due to have a prostatectomy should not just fret about this in secret, he should talk to his doctors about it - his GP, his consultant, his surgeon. Most importantly, the doctor should respect his fears, and him for coming to air them with him. It’s not easy for any man to do this, and if he succeeds in overcoming his reluctance to do so, the doctor should recognise what that has cost him. If the doctor reacts badly, it might have catastrophic effects: it might just send him scuttling back to his burrow, his pride injured, and he might never be able to take the risk again. Only when both doctor and patient can talk about this calmly, sensibly, realistically, will the patient be reassured that it will have no effect on his sexuality - neither on his libido, nor his ability to obtain or maintain an erection, nor on his performance.
Retrograde ejaculation
What it may well do, however, is cause him to be infertile after the operation. Even a man who has no intention of becoming a father again may find the idea of losing his potential to be a father very distressing. A man may find this emasculating, as if it were questioning his manhood. He’s only lost his ability to procreate, not his sexuality, but this can have a devastating effect on him. This is reminiscent of a woman who regrets the loss of her womb after a hysterectomy, even though she is beyond childbearing, and feels she has lost her femininity. A doctor should have the sensitivity to talk to his patient about this. Only with patience and understanding can he help
him come to terms with his feelings of fear and loss. Retrograde ejaculation will not make a man impotent, nor - in most cases - will it prevent him from having orgasms. It will, however, make the sensation of orgasm a different one - and, in all honesty, probably not as good. Some women, too, are disappointed by the new feeling of a ‘dry’ climax in their male partner. These changes in a man’s sexuality should be addressed beforehand. He should be told what to expect. A sensitive doctor will also help a couple come to terms with their new-found sexuality.
Impotence
It is possible, though by no means certain - nor even common -that prostatectomy may cause impotence Some men are frightened that it might have this effect, probably because they have heard tales of the old perineal prostate operation (which is hardly ever done nowadays) or the radical prostatectomy in which the entire prostate, including the capsule in which it is enclosed, is removed (sometimes performed for prostate cancer). In both these operations, the nerves supplying the penis were sometimes cut, which led to a man’s impotentence. The problem of impotence is therefore unlikely but it may arise. If a man is very frightened that the operation may lead to impotence, he may actually experience a kind of psychological impotence afterwards. This underlines how important it is for a man to be reassured before the operation. If a psychological problem does occur, a counsellor or sex therapist should be able to deal with it.
An excuse to avoid sex
In spite of all the evidence that prostate surgery has no effect at all on a man’s sexuality (other than retrograde ejaculation), it does occasionally seem to happen. An obvious explanation for this is that some men may use surgery as an excuse to avoid sex, which they had stopped enjoying ages ago anyway. Occasionally, if a man is not in very good health, a prostate operation - which is, after all, a major operation requiring a long convalescence period - may be enough to push his sexuality over the edge.
Generally, though, most men do not have any problems with their sex lives after the operation. In fact, a man may actually find that his sex life has greatly improved since he had his prostatectomy, if only because he now has full control of his bladder.
Jul
1
Prescription Drugs for Depression Treatment Available Online without Prescription
July 1, 2009 | Leave a Comment
Generic Antidepressants Online without a prescription: Paxil, Effexor, Abilify, Celexa, Cymbalta, Lexapro, Wellbutrin, Zoloft, Seroquel, Risperdal, Prozac and others.
There are numerous effective drugs for depression treatment (antidepressants) available on the market today. You can buy antidepressantst online from internet pharmacy without a prescription. The most popular and widely prescribed antidepressants today are Paxil, Effexor, Abilify, Celexa, Cymbalta, Lexapro, Wellbutrin, Zoloft, Seroquel, Risperdal, Prozac and others. However, being a serious drug any antidepressant must be carefully selected by you and your doctor and already in the course of your treatment which is usually a rather long time you can easyly go online and buy almost any antidepressants or generic antidepressants which are same drugs from on line pharmacy.
Depression is a natural reaction to disappointment and grief, but it is normally brief and self-limiting. Excessive or prolonged depression is an illness, sometimes without apparent cause, and it appears to be linked with an imbalance in the brain of certain amine substances, including serotonin, that act as neuroregulators. Antidepressants drug therapy can assist in restoring a normal balance, but prolonged treatment is usually necessary to evoke a full response. The drugs in most frequent use are the tricyclic antidepressants, so-called from their chemical structure, together with the monoamine oxidase inhibitors (MAOIs). All the tricyclic antidepressants have the same general pattern of activity, but some, such as amitriptyline, are more sedative than others. Some related compounds have a similar antidepressant action, but blood counts are essential with mianserin and convulsions have been reported after maprotiline therapy.The monoamine oxidase inhibitors are phenelzine, isocarboxazid and tranylcypromine. They are now used less often, as they are potent drugs that react with many other therapeutic agents, as well as certain food such as cheese, broad beans, pickled herring, and meat/yeast extracts. A new MAGI is moclobernide, which has a more selective and reversible action on the A-form of MAO. Particular care is necessary with tranylcypromine. Fluvoxamine, fluoxetine, paroxetine and sertraline are newer drugs that have a more selective antidepressant action mediated by inhibiting the re-uptake of serotonin. They are referred to collectively as SSRIs (selective serotonin re-uptake inhibitors).
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