Saturday, June 29, 2013

Ascites Symptoms


Ascites is a condition where there is accumulation of fluid in the abdominal cavity. This fluid is normally clear, pale or slightly straw colored in nature. The abdominal cavity, or peritoneal cavity is located just below the chest cavity. These two cavities are separated by the diaphragm. This kind of accumulation of fluid in the abdominal cavity can occur due to many systemic diseases and disorders. One of the most common causes of ascites is liver disease or liver cirrhosis. This mostly occurs as a result of an increase in the pressure of liver blood flow, which is known as portal hypertension. This kind of accumulation of fluid is similar to edema. Sometimes, ascites may also occur due to salt and water retention, congestive heart failure, kidney failure, peritoneal inflammation, etc.

Symptoms of Ascites

In the initial stages of ascites, there may be a possibility that there are no symptoms exhibited. This is so because when there is only slight accumulation of fluid in the peritoneal cavity, there are normally no systemic changes or significant symptoms seen, and hence, the patient will not report to the doctor at this stage. However, after sometime, when the fluid accumulation reaches such a stage that there are visible symptoms or the patient feels discomfort, only then does he visit the doctor to get the condition diagnosed. Given below are the various signs and symptoms of ascites that one needs to lookout for:

Abdominal Ascites
When there is accumulation of only about 100-400 ml of fluid in the abdominal cavity, it is generally said to be a case of mild ascites. Mild ascites symptoms include slight abdominal pain and discomfort. However, when there is accumulation of more than 500 ml of fluid, then there is abdominal pain and bloating seen. In fact, one of the main abdominal bloating causes is ascites. When suffering from severe ascites, the patient normally complains of abdominal distension and abdominal heaviness. In fact, often the large abdominal distension is a common physical concern for patients, and this is often the main factor that prompts patients into going to the doctor. On percussion of the abdomen, there is shifting dullness, and a fluid wave or fluid thrill is seen on tapping one side of the abdomen. A fluid wave means, a wave like effect is seen on the skin of the abdomen when the side of the patient is tapped, as there is movement of fluid in the cavity.

Other Symptoms
Sometimes, if the swelling is so large that the fluid impinges on the diaphragm, the person may feel shortness of breath, as the pressure on the diaphragm hinders its normal functioning. At times, the fluid may even pass the diaphragm and surround the lungs, leading to pleural effusion. Other symptoms include easy bruising, gynecomastia, mental confusion, paroxysmal nocturnal dyspnea, etc. If the person has ascites due to bacterial inflammation of the peritoneal cavity lining, then there may also be systemic symptoms, like fever, fatigue, weight loss, etc. One of the rarer type of ascites is chylous ascites, where one of the main chylous ascites symptoms is accumulation of milky white fluid in intraperitoneal area, as this kind of ascites occurs due to obstruction of the drainage of abdominal lymph glands.

Thus, ascites, though in itself, is not an actual disease but is merely a symptom that could indicate a major underlying disease or condition, it is important to try to identify it at the earliest, so as to treat the underlying disease, and prevent any further systemic complications.

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Thursday, June 27, 2013

Thoracic Outlet Syndrome: Causes, Symptoms and Treatment


Thoracic outlet is situated in the area between the neck and the chest which is right at the top of the ribcage. It constitutes various anatomical structures which passes through this area and are very complicated in nature. It includes esophagus, trachea, nerves and blood vessels. Thoracic outlet syndrome causes severe pain in the region of neck, shoulder, chest, arm, and/or hand. The reason behind the pain is the compression of blood vessels and nerves which directly affects the thoracic region and causes pain and abnormal sensations.

People suffering from thoracic outlet syndrome often confuse it with angina pain, which occurs during a heart attack. The angina pain and the pain in thoracic outlet is quite different. In angina, the pain appears while walking and in thoracic outlet syndrome it does not appear while walking. Secondly, the pain can be felt when the arm is raised, while it is not the case with angina pain.

Types and Symptoms of Thoracic Outlet Syndrome
  • True Neurogenic: This is a rare disorder which is caused by congenital anomalies. It is found mainly in middle-aged women and occurs on one side of the body. The symptoms include weakness and wasting of hand muscles and numbness in hand.
  • Arterial: It affects both the genders equally but mostly seen in young people. It is caused due to congenital anomaly and affects one side of the body. Cold sensitivity in the hands and fingers, pain and numbness in fingers, finger sores and inadequate blood circulation are the symptoms of arterial thoracic syndrome.
  • Disputed: As the name suggests there is a dispute among doctors about its existence. It is caused due to nerve injury in the brachial plexus. The symptoms are pain, weakness and fatigue.
  • Venous: The actual cause of venous thoracic syndrome is unknown. It targets both the genders and often caused due to unusual and prolonged limb exertion. It is also known as Paget-Schroetter Syndrome and sometimes called Effort Thrombosis. The symptoms are pain and swelling of arms.
  • Traumatic: It is caused due to traumatic injury or repetitive activities. The symptoms are pain, burning sensations in hands, arms, legs or feet. The symptoms get worse if the body posture is not right.
Causes
There are various factors which contributes to thoracic outlet syndrome. A person's overall physical structure can cause this syndrome; the abnormal anatomy may exert pressure on the nerves or blood vessels. Malformed ribs, and too narrow opening between the collar bones and the first rib are some of the abnormalities which can cause thoracic outlet syndrome. Poor posture is one of the leading causes which can be easily worked upon. A major symptom is pain in the affected area, the patient's arms and hands become weak. When the patient is exposed to cold, small arteries in the finger contract and turn pale. In severe cases, it can lead to gangrene due to compression of blood vessels. This condition is called Raynaud's syndrome.

Treatment
There are no particular diagnostic tests which can detect the syndrome. The diagnosis is done after ruling out possibilities of other diseases and assessing the overall condition of the patient. Tests such as Adson test and Allen test can be used to detect the presence of thoracic outlet syndrome. Other tests such as chest X-ray, color flow duplex scanning, ultrasound analysis also helps to diagnose the ailment. Physical therapy can be helpful in treating thoracic outlet syndrome. The main area of consideration is to improve the posture of the affected person. In rare cases, surgery is performed when physical therapy doesn't work. Exercises done on a regular basis on consultation of a doctor can help in treating thoracic outlet syndrome effectively.

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