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Wednesday 18 September 2019

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Saturday 14 September 2019

Cystitis

                                                           Cystitis




    Is the medical term for inflammation of the bladder. Most of the time, the inflammation is caused by a bacterial infection, and it's called a urinary tract infection UTI. 

   Cystitis usually occurs when the urethra and bladder, which are normally sterile, or microbe-free, become infected with bacteria.      Cystitis is an infection of the bladder wall that can lead to ongoing discomfort. Bacteria fasten to the lining of the bladder and cause the area to become irritated and inflamed. 

   Cystitis affects people of both sexes and all ages. It is more common among females than males because women have shorter urethras. 

    Around 80% of all urinary tract infections are caused by bacteria from the bowel that reach the urinary tract. Most of these bacteria form part of the healthy intestinal flora, but once they enter the sterile space in the urethra and bladder, they can cause a UTI. UTIs are the most common hospital-acquired infections in the united states, especially among patients using urinary catheters. 

  A urinary tract infection is a bacterial infection that affects any part of the urinary tract. The main etiologic agent is Escherichia coli. Although urine contains a variety of fluids, salts, and waste products. It does not usually have bacteria in it. When bacteria get into the bladder or kidney and multiply in the urine, they may cause a UTI. 

 The most common type of UTI is acute cystitis often referred to as a bladder infection. An infection of the upper urinary tract or kidney is known as pyelonephritis and is potentially more serious. Symptoms include frequent feeling and need to urinate, pain during urination, and cloudy urine. 

 Urinary tract infections are more common in women. They usually occur in the bladder or urethra, but more serious infections involve the kidney. A bladder infection may cause pelvic pain, increased urge to urinate, pain with urination and blood in the urine. A kidney infection may cause back pain, nausea, vomiting, and fever. 

Symptoms:

 The most common symptoms of a bladder infection are burning with urination dysuria, frequency of urination, an urge to urinate, without vaginal discharge or significant pain. An upper urinary tract infection or pyelonephritis may additionally present with flank pain and fever.

   The symptoms of urinary tract infections may vary with age and the part of the urinary system that was affected. In young children, urinary tract infection symptoms may include diarrhea, loss of appetite, nausea, and vomiting, fever and excessive crying that cannot be resolved by typical measures.  Older children, on the other hand, may experience abdominal pain, or incontinence.       Lower urinary tract infections in adults may manifest with symptoms including hematuria, inability to urinate despite the urge and malaise. 

  Other signs of urinary tract infections include foul-smelling urine and urine that appears cloudy. Depending on the site of infection, urinary tract infections may cause different symptoms.  

   Urethritis does not usually any other symptoms besides dysuria. If the bladder is however affected (cystitis), the patient is likely to experience more symptoms including lower abdomen discomfort, low-grade fever, pelvic pressure and frequent urination all together with dysuria. 
   Infection of the kidneys(acute pyelonephritis) typically causes more serious symptoms such as chills, nausea, vomiting and high fever. 

  Common symptoms:

 - Trace of blood in the urine
- Dark, cloudy, or strong-smelling urine
- Pain just above the pubic bone, in the lower back, or in the abdomen
- Burning sensation when urinating
- Urinating frequently or feeling the need to urinate frequently 

 Elderly individuals may feel weak and feverish but have none of the other symptoms mentioned above. They may also present with altered mental status. There is a frequent need to urinate, but only small amounts of urine are passed each time. 

 When children have cystitis, they may have any of the symptoms listed above, plus vomiting and general weakness. Some other illness or conditions have similar symptoms to cystitis, these include:
  
 Urethritis, or inflammation of the urethra
 Bladder pain syndrome
 Prostatitis, or inflammation of the prostate gland
 Benign prostatic hyperplasia, in men 
 Lower urinary tract syndrome 
 Gonorrhea
 Chlamydia 
 Candida, or Thrush

Causes

 There are many possible causes of cystitis. Most are infectious, and the majority of these cases stem from an ascending infection. The bacteria enter from the external genitourinary structures.

- Tampon use: when inserting a tampon, there is a slight risk of bacteria entering via the urethra. 

- Inserting, changing, or prolonged use of a urinary catheter, there is a chance the catheter will carry bacteria along the urinary tract. 

- Diaphragm for birth control: There is a higher incidence of cystitis among women who use the diaphragm with spermicides, compared with sexually active women who do not use one.    

- Full bladder: If the bladder is not emptied completely, it creates an environment for bacteria to multiply. This is fairly common among pregnant women or men whose prostates are enlarged. 

- Sexual activity: Sexually active women have a higher risk of bacteria entering via the urethra. 

- Blockage in part of the urinary system that prevents the flow of urine. 

- Other bladder or kidney problems. 

- Frequent or vigorous sex: This increases the chances of physical damage, which in turn increases the likelihood of cystitis. This is sometimes called honeymoon cystitis. 

- Falling estrogen levels: During menopause, estrogen levels drop, and the lining of a women's urethra gets thinner. The thinner the lining becomes, the higher the chances are of infection and damage. After menopause, the risk is higher. 

- Gender: A woman's urethral opening is nearer the anus than a man's, so there is a higher risk of bacteria from the intestines the urethra. 

- Mucus reduction: During menopause, women produce less mucus in the vaginal area. This mucus normally acts as a protective layer against bacteria. 

- Radiotherapy: Damage to the bladder can cause late radiation cystitis. Women on hormone replacement therapy. Lower risk of developing cystitis compared with menopausal women not on HRT. However, HRT has its own set of risks, so it is not routinely used for the treatment of infections cystitis in postmenopausal women. 

Types of Cystitis:

  Cystitis can be either acute or interstitial. Acute cystitis is a case of cystitis that occurs suddenly. Interstitial cystitis is a chronic or long- term case of cystitis that affects multiple layers of bladder tissue. 

Both acute and interstitial cystitis have a range of possible causes. The cause of cystitis determines the type. The following are types of cystitis: 

Bacterial Cystitis:

 Bacterial cystitis occurs when bacteria enter your urethra or bladder and cause an infection. This can also result when normally growing bacteria in your body becomes imbalanced. The infection leads to cystitis or inflammation in your bladder. 

It is important to treat a bladder infection. I the infection spreads you your kidneys it can become a serious health issue. 

 Drug-induced cystitis

  Certain medications can cause your bladder to become inflamed. Medicines pass through your body and eventually exit through your urinary system. Some medications can irritate your bladder as they exit your body. For example, the chemotherapy drugs cyclophosphamide and ifosfamide can cause cystitis.

Radiation cystitis:

 Radiation therapy is used to kill cancer and shrink tumors, but it can also damage healthy cells and tissues. Radiation treatment in the pelvic area can cause your bladder to become inflamed. 

Foreign body cystitis:

 Ongoing use of a catheter, a tube used to facilitate the release of urine from the bladder, can increase your risk of bacterial infection, and damage tissues in the urinary tract. Both bacteria and damaged tissues can cause inflammation. 

Chemical cystitis

 Certain hygiene products can irritate your bladder. Products that may cause cystitis to include: 

- Spermicidal jellies
- Use of a diaphragm with spermicide
- Feminine hygiene sprays
- Chemicals from a bubble bath

 Cystitis associated with other conditions:

Sometimes cystitis occurs as a symptom of other medical conditions, such as: 

- Diabetes
- Kidney stones
- HIV
- Enlarged prostate 
- Spinal injuries 

Diagnosis:

 A doctor will ask the patient some questions, carry out an examination, and do a urine test. The urine test will either be sent to a laboratory, or the doctor may use a dipstick. Urine dipstick result comes back quickly while the patient is still in the office. 

Urine culture or catheterized urine specimen may be performed to determine the type of bacteria in the urine. After finding out which specific bacterium is causing the infection, the doctor will prescribe an oral antibiotic. 

Most doctors will also offer to test for a sexually transmitted infection. SITs often have similar symptoms to cystitis.  

Home care:

 Home care treatments can help ease discomfort. Common methods are:

- Applying heating pads abdomen or back
- Over- the - counter pain relievers, such as ibuprofen and acetaminophen 
- Sitz baths to cleanse the pelvic area 

   Sometimes you can manage cystitis symptoms at home, without taking medication. These should not replace antibiotics if they are needed to treat a UTI. 

Common home therapy methods are:

- Cranberry juice or tablets
- Drinking lots of fluids 
-  Wearing cotton underwear and loose-fitting clothes
- Avoiding any food or beverages that you suspect make your symptoms worse. 

While recovering from cystitis, you should:

- Drink plenty of fluids
- Avoid caffeinated drinks, as these can irritate your bladder
- Urinate frequently, rather than holding it
- Wear cotton underwear and loose-fitting clothes 
Outlook for cystitis:

 The outlook of cystitis is dependent on the cause of the symptoms. In general, the outlook for cystitis is good. However, it is important to treat the underlying condition as soon as possible. 


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Saturday 7 September 2019

Dementia

                                                             Dementia


(please remember the real me when I can not remember you)




       Dementia comes from a Latin word "Demens" which means "Absence of mind" chronic impairment of thinking that affects a persons ability to function in a social or occupational setting. The impairment is severe enough to interfere with the patient's ability to perform routine activities. 

According to WHO

    Dementia is a syndrome, usually of a chronic or progressive nature, in which there is deterioration in cognitive function beyond what might be expected from normal aging. It affects memory, thinking, orientation, comprehension, calculating, learning capacity, language, and judgment. Consciousness is not affected. The impairment in cognitive function is commonly accompanied and occasionally preceded, by deterioration in emotional control, social behavior, or motivation.  

     Dementia is not a specific disease. It's an overall term that describes a group of symptoms associated with a decline in memory or other thinking skills severe to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80% of cases. Vascular dementia, which occurs after a stroke, is the second most common dementia type. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies. Dementia is often incorrectly referred to as senility or senile dementia which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging. 

  Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. A progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging. Areas particularly affected include memory, attention, judgment, language, and problem solving, madness or insanity. Alzheimer's disease international estimates that are currently 30 million people with dementia in the world with 4.6 million new cases annually. The number of people affected will over 100 million by 2050. 

  The age group most commonly affected by this illness is 60 and over still, there is some risk group that is not age-dependent, such as people that suffer from high blood pressure, smokers high cholesterol patients and so on. Dementia is a brain disorder, beings after the age of 60 that seriously affects a person's ability to carry out daily activities. It begins slowly, involving the parts o the brain that control thought, memory & language. People with AD may have trouble remembering recent events, name of people.
 Over times symptoms get worse and the patient might have trouble in speaking, reading & writing. They may forget how to brush their teeth or comb their hair, become anxious or aggressive, and wander away from home. 

Causes:

  Dementia is caused by damage to brain cells, this dan-mages interferes with the ability of brain cells to communicate with each other. When brain cells can not communicate normally, thinking, behavior and feeling can be affected. The brain has many distinct regions, each of which is responsible for different function (for example, memory, judgment, and movement). When cells in a particular region are damaged, that region cannot out its functions normally. 

Causes divided into primary and secondary causes




 Primary Causes:

 - Alzheimer's disease
  Is the most common form of dementia, and the disease most people associate with memory loss. Usually diagnosed after age 80 and is uncommon in people under the age of 65. 

-Vascular dementia:
   Occurs when small strokes or brain lesions impair blood flow to the brain. It is the cause of 20% of dementia cases, making it the second most common cause after Alzheimer's disease. 

- Pick's Disease:
   Symptoms are often hard to distinguish from Alzheimer's disease. Pick's disease damages nerve cells in the brains frontal and temporal lobes. Nerve cells affected by Pick's disease weaken and eventually die. 

-Huntington's disease:
   Is a genetically inherited neurological disease that can dementia. Huntington disease causes behavioral changes and chorea. The usual age of Huntington's disease onset is between forty and sixty years old. 

- Parkinson's disease:
   Is a progressive neurological disease that affects movement and muscle control. Symptoms of Parkinson's disease include tremors, balance problems, difficulty walking, and a rigid posture. 

-Lewy- body dementia:
  Related to Alzheimer's disease. The cause is the presence of abnormal substances called Lewy-body in parts of the brain such as cortex and brain stem. Lewy body dementia causes classical dementia symptoms, including memory loss. The disease can also cause hallucinations, depression, and paranoia. 

Secondary causes:

 Dementia like symptoms can develop as a result of an underlying condition can be treated, the symptoms will generally improve. The following are some of the common secondary causes that can lead to dementia. 

-Alcohol Dementia and substance abuse:
 Alcohol abuse can lead to symptoms of dementia. The long term toxic effects of alcohol on the brain are enough to cause it. Symptoms can often be improved by abstaining from alcohol. 

-Infections diseases:
  A number of infections that affect the central nervous system have been known to cause dementia symptoms, including HIV, meningitis, and encephalitis. 

Medication:
  As people age, they tend to require more medication for their health. Many of the medications include dementia symptoms as aside effect. The list of medications is incredibly long and includes such common medication as anti-diarrhea medication, anti-epileptic medications, antihistamines, cold and flu medication, sleeping pills, tricyclic antidepressants. 

Pseudo Dementia:
  Depression can result in dementia symptoms, including memory loss and a lack of motivation. Elderly people dealing with health problems, the loss of spouse, or loneliness are particularly susceptible to depression. Treating depression often result in the reversal of dementia symptoms. 

Metabolic disorders
    Metabolic disorders can also symptoms of dementia. These disorders include cortisol hormone imbalances, diabetes, electrolyte levels, kidney failure, liver diseases, and thyroid disorders. 

Wernicke- Korsakoff syndrome:
    It results from a deficiency in thiamine (Vitamin B1) and is often due to chronic, severe alcoholism. It can also result from general malnutrition, eating disorders, or the effects of chemotherapy. Dementia due to Wernicke- Korsakoff syndrome involves confusion, apathy, hallucination, communication problems, and severe memory impairment.  

Brain Tumors:
   Brain tumors put pressure on and damage the surrounding brain tissue. A brain tumor can cause a number of symptoms, including dementia. The tumor may originate in the brain or may have spread to the brain from other organs. 

Signs and symptoms:
  
 Dementia affects each person in a different way, depending upon the impact of the disease and the person before becoming ill. The signs and symptoms linked to dementia can be understood in three stages. 

Early-stage:
   The early stage of dementia is often overlooked because the onset is gradual. Common symptoms include: 
- Forgetfulness
- Losing track of the time
- Becoming lost in familiar places. 

Middle stage:
  As dementia progresses to the middle stage, the signs and symptoms become and more restricting. These include:
- Becoming forgetful of recent events and people's names
- Becoming lost at home
- Having increasing difficulty with communication
- Needing help with personal care
- Experiencing behavior changes, including wandering and repeated questioning. 

Late-stage:
  The late stage of dementia is one of near-total dependence and inactivity. Memory disturbances are serious and the physical signs and symptoms become more obvious. Symptoms include:
- Becoming unaware of the time and place
- Having difficulty recognizing relatives and friends
- Having an increasing need for assisted self-care
- Having difficulty walking
- Experiencing behavior changes that may escalate and including aggression. 

Handling Money:
  Trouble remembering simple words, often dementia sufferers will substitute inappropriate words without realizing. 

Common forms of dementia:
  There are many different forms of dementia. Alzheimer disease is the most common form and may contribute to 60-70% of cases. Other major forms include vascular dementia, dementia with Lewy bodies, and a group of diseases that contribute to frontotemporal dementia. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist. 

Rates of dementia:
  Worldwide, around 50 million people have dementia, with nearly 60% living in low and middle-income countries. Every year, there are nearly 10 million new cases. The estimated proportion of the general population aged 60 and over with dementia at a given time is between 5-8%. The total number of people with dementia is projected to reach 82 million in 2030 and 152 in 2050. Much of this increase is attributable to the rising numbers of people with dementia living in low and middle-income countries. 

Diagnosis:

 There is no one test to determine if someone has dementia. Doctors diagnose Alzheimer's and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behavior associated with each type. Doctors can determine that a person has dementia with a level of certainty. But it's harder to determine the exact type of dementia because of the symptoms and brain changes of different dementias can overlap. In some cases, a doctor may diagnosis dementia and not specify a type. If this occurs it may be necessary to see a specialist such as a neurologist or a psychologist.     

    Diagnosis requires a medical history, physical examination, including neurological examination and appropriate laboratory tests. 
Taking a thorough medical history involves gathering information about the onset duration, and progression of symptoms, any possible risk factors for dementia, such as a family history of the disorder or other neurological diseases, history of stroke, and alcohol or other drug use. 

The various laboratory investigations include

- Thyroid hormone tests to check for an underactive thyroid.
- Vitamin B12 blood test to look for a vitamin deficiency. 
- Complete blood count, or CBC, to look for infection.
- ALT or AST, blood tests that check liver function. 
- Syphilis test to look for this disease. 
- Chemistry screen to check the level of electrolytes in the blood and to check kidney function. 
- Glucose test to check the level of sugar in the blood. 
- MRI or CT to look for tumors. 

Other lab tests that may be done include:

- HIV testing to look aids
- Erythrocyte sedimentation rate, a blood test that looks for signs of inflammation in the body. 
- Toxicology screen, which examines blood, urine, or hair to look for drugs that could be causing problems. 
- Antinuclear antibodies, a blood test used to diagnose autoimmune diseases
- Testing for heavy metals in the blood, such as a lead test. 

Risk factors and prevention:

 Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of aging. Further, dementia does not exclusively affect older people- young-onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of dementia by getting regular exercise, not smoking, avoiding harmful use of alcohol, controlling and blood sugar levels, Additional risk factors include depression, low educational attainment, social isolation, and cognitive inactivity. 

Social and economic impact:

 Dementia has significant social and economic implications in terms of direct medical and social care costs, and the costs of informal care. In 2015, the total global societal cost of dementia was estimated to be 818 billion, equivalent to 1.1% of global gross domestic product. The total cost as a proportion of GDP varied from 0.2% in low and middle-income countries to 1.4% in high-income countries. 

Impact on families and carers:

 Dementia can be overwhelming for the families of affected people and for their carers. Physical, emotional and financial pressure can cause great stress to families and carers, and support is required from the health, social and legal systems. 

WHO response:

 WHO recognizes dementia as a public health priority. On May 2017, the World Health Assembly endorsed the Global action plan on the public health response to dementia 2017- 2025. The plan provides a comprehensive blueprint for action, for policy-makers, international, regional and national partners, and WHO as in the following areas, addressing dementia as a public health priority, increasing awareness of dementia and establishing dementia-friendly initiatives, reducing the risk dementia, diagnosis, treatment and care, information systems for dementia, support for dementia carers, and research and innovation. An international surveillance platform, the global Dementia Observatory, has been established for policymakers and researchers to facilitate monitoring and sharing of information on dementia policies, service delivery, epidemiology, and research. 

 WHO has developed Towards a dementia plan, a WHO guide, which provides guidance to the Member States in creating and operationalizing a dementia plan. The guide is closely linked to WHO's GDO and includes associated tools such as a checklist to guide the preparation, development, and implementation of a dementia plan. It can be used for stakeholder mapping and priority setting. 

  WHO Guidelines on risk reduction of cognitive decline and dementia provide evidence-based recommendations on interventions for reducing modifiable risk factors for dementia, such as physical inactivity and unhealthy diets, as well as controlling medical conditions linked to dementia, including hypertension and diabetes. Dementia is also one of the priority conditions in the WHO mental health gap action program, which is a resource for generalists, oarticular in low- and middle-income countries, to help them provide first-line care for mental, neurological and substance use disorders.  



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Sunday 1 September 2019

Anorexia Nervosa

                                                   Anorexia Nervosa




  An eating disorder causing people to obsess about weight and what they eat.


Anorexia Nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss. 

 The condition commonly involves emotional challenges, an unrealistic body image, and an exaggerated fear of becoming overweight or obese. If often begins during the teenage years or early adulthood, but it can begin in the preteen years. It is the third most common chronic illness among teens. 

  Eating disorders affect some 30 million men and women in the United States. Both men and women can develop anorexia, but it is 10 times more common in females. Nearly 1 in every 100 American women will experience anorexia some time. Anorexia nervosa is different from anorexia, which means a loss of appetite or inability to eat. 

Fast facts on Anorexia Nervosa:

  Here are some key points about anorexia nervosa
. Anorexia nervosa is a psychological condition that involves an eating disorder. 
. Symptoms include a very low body mass index, a refusal to eat, and attempts to lose weight, even when body mass index is very low. 
. It is thought to be triggered by a combination of biological, environmental, and genetic factors. 
. Treatment can take some time, but with a combination of counseling and other types of therapy, recovery is possible. 

Anorexia nervosa is a psychological condition and an eating disorder in which the individual loses more weight than is healthy for their height and age. The individual will maintain a body weight of 85% or less of their expected weight. 

. A person with anorexia will internationally restrict their food intake, generally due to a fear of being or becoming fat, even when their body mass index is already low. They may also practice excessive, use laxatives, and vomit to reduce weight, but to a lesser extent then those diagnosed with bulimia. 

.Complication can be severe. An eating disorder is reported t have the highest mortality rate of any mental illness. Treatment includes hospitalization and counseling. 

Symptoms:

 Anorexia nervosa is a complex condition, but the main sign is usually severe weight loss. The person may also talk about being overweight, although objective measures, such as BMI, show that this is not true.
 Behavioral changes may include a refusal to eat, exercising excessively, and use of laxatives or vomiting after consuming food. 

- Severe loss of muscle mass

- Hypotension, or blood pressure

- Listlessness, fatigue, exhaustion 
- Lightheadedness or dizziness 
- Hypothermia, or low body temperature, and cold hands and feet
- Bloated or upset stomach and constipation
- Dry skin
- Alopecia, or hair loss
- Swollen hands and feet
- Infertility 
- Insomnia 
- Loss of menstruation or less frequent periods
- Brittle nails
- Osteoporosis, or loss of bone density
- Irregular or abnormal heart rhythms
- Lanugo, fine downy hair growing all over the body, and increased facial hair signs of vomiting include bad breath and tooth decay, due to the acid in the vomit. 

Psychological signs and symptoms include:

- Obsession with food, for examples, reading cookery books
- Excessive concern about being fat or overweight 
- Frequently measuring and weighing themselves and inspecting their bodies in the mirror
- Lying about food intake
- Not eating or refusing to eat
- Reduce sex drive 
- Self- denial
- Lack of emotion or a depressed mood 
- Over-exercising
- Irritability
- Memory loss
- Obsessive-compulsive behavior 
Food and eating become associated with guilt. It may be difficult to talk to the person about a possible problem, as they will likely refuse to acknowledge that anything is wrong. 

Causes:

 No single cause has been identified for anorexia nervosa. It probably happens as a result of biological, environmental, and psychological factors. 

- Being susceptible to depression and anxiety
- Having difficulty handling stress. 
- Being excessively worried, afraid, or doubtful about the future
- Being perfectionist and overly concerned about rules. 
- Having a negative self-image
- Having eating problems during early childhood or infancy
- Having had an anxiety disorder during childhood. 
- Holding specific regarding beauty and health, which may be influenced by culture or society
- Having a high level of emotional restraint or control over their own behavior and expression, the person may be overly worried about their weight and shape, but this is not necessarily the key factor. 

  33 and 50 % of people with anorexia also have a mood disorder, such as depression, and around half have an anxiety disorder, such as Obsessive-compulsive disorder and social phobia. This suggests that negative emotions and a low self-image may contribute, in some cases. A person may develop anorexia Nervosa as a way of gaining control of some of their life. As they exert control of their food intake, this feels like success, and so the behavior continues. 

Environmental factors:

 Environmental factors may include the hormonal changes that occur during puberty, plus feelings of anxiety, stress, and low self-esteem. The fashion industry and media messages suggesting that being thin is beautiful may have an impact. 
- Physical, sexual, emotional or other types of abuse
- Family or other relationship problems
- Being bullied
- Fear and pressure to succeed 
- A stressful life event, such as bereavement or becoming unemployed.

Genetic Factors:

 Studies have found that some people with eating disorders may have an imbalance in certain brain chemicals that control digestion, appetite, and hunger. Further research is needed to confirm this. Genetic factors may affect a person's susceptibility to eating disorders, as they can run in families. between 50 to 80% of the risk for anorexia is thought to be genetic.  

Vicious cycle:

Once a person starts losing weight, low weight and lack of nutrients may contribute to brain changes in a way that reinforces the behaviors and obsessive thoughts related to anorexia nervosa. The changes could involve the part of the brain that controls appetite, 

Once a person starts losing weight, low weight and lack of nutrients may contribute to brain changes in a way that reinforces the behaviors and obsessive thoughts related to anorexia nervosa. 

The changes could involve the part of the brain that controls appetite or they could increase the feelings of anxiety and guilt that become associated with eating. 

  Anorexia nervosa may have different gut microbial communities than those without the condition. The authors suggested that this could contribute to anxiety, depression, and further weight loss. People with anorexia nervosa are less able to differentiate between different types of positive emotion. This can lead to further weight-loss behavior, as self- deprivation becomes associated with a sense of pride. 



Diagnosis:

 Diagnosis and prompt treatment increase the chance of a good outcome. 

   The physician will ask the patient about weight loss, how they feel about their weight, and, for females, about menstruation. It can be hard fo the patient to open up and speak frankly about themselves. It can take years to confirm a diagnosis, especially if the person was previously obese. If the physician detects signs of anorexia nervosa, they may order tests to rule out other underlying medical conditions with similar signs and symptoms. 
- Diabetes, Addison's disease
- Chronic infections, Malabsorption
- Immunodeficiency, Cancer
- Inflammatory bowel disease, Hyperthyroidism 

Complications

 Complications can affect every body system, and they can be severe. 

Physical complications include

- Cardiovascular problems: These include low heart rate, low blood pressure, and damage to the heart muscle. 

- Blood problems: There is a higher risk of developing leukopenia, or low white blood cell count. and anemia, a low red blood cell count. 

Gastrointestinal problems: Movement in the intestines slow significantly when a person is severely underweight and eating too little, but this resolves when the diet improves. 

 Kidney problems: Dehydration can lead to highly concentrated urine and more urine production. The kidneys usually recover as weight levels improve. 

Hormonal problems: Lower levels of growth hormones may lead to delayed growth during adolescence. 







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