Cholestasis

CHOLESTASIS

Cholestasis is a condition where bile can’t flow from the liver to the duodenum. Bile formation is a secretary function of the liver. It begins in bile Canaliculi that form between two adjacent surfaces of liver cells similar to the terminal branches of a tree. The Canaliculi join each other to form larger structures, sometimes referred to as canals of hering, which themselves join to form small bile ductules that have an epithelial surface. The ductules join to form bile ducts that eventually form either the right main hepatic duct that drains the right lobe of the liver and the left main hepatic duct draining the left lobe of the liver. The two ducts join to form the common hepatic duct, which in turn joins the cystic duct from the gall bladder, to give the common bile duct. This duct then enters the duodenum at the ampulla of Vater.       

Causes: - The causes of cholestasis are divided into two groups:

i.)                Those originating within the liver and

ii.)              Those originating outside the liver. 

Within The Liver: - Causes include:

i.)         Acute Hepatitis,

ii.)       Alcoholic Liver Disease,

iii.)      Primary biliary Cirrhosis with inflammation and scarring of the         

            bile ducts,                  

iv.)      Cirrhosis due to viral hepatitis B or C,

v.)       Drugs,

vi.)      Hormonal effects on bile flow during Pregnancy and

vii.)     Cancer that has spread to the liver.

Outside The Liver: - Causes include:

i.)                A stone in a bile duct, narrowing of a bile duct,

ii.)              Cancer of a bile duct,

iii.)           Cancer of the Pancreas and

iv.)            Inflammation of the Pancreas.

Symptoms: -

i.)                Jaundice, dark urine, light colored stools and generalized itchiness are characteristic Symptoms of Cholestasis.

ii.)              Jaundice results from excess bilirubin deposited in the skin, and dark urine results from excess bilirubin excreted by the kidneys.

iii.)           Retention of bile products in the skin may cause itching, with subsequent scratching and skin damage.

iv.)            Stools may become light-colored because the passage of bilirubin into the intestine in blocked.

v.)              Stools may contain too much fat because bile can’t enter the intestine to help digest fat in foods.

vi.)            Fatty stools may be foul-smelling. The lack of bile in the intestine also means that calcium and vitamin D are poorly absorbed. If Cholestasis Persists, a deficiency of these nutrients can cause loss of bone tissue. Vitamin K, which is needed for blood clotting, is also poorly absorbed from the intestine, causing a tendency to bleed easily.

vii.)         Prolonged jaundice due to cholestasis produces a muddy skin color and fatty yellow deposits in the skin. Whether the person has other symptoms, such as abdominal pain, loss of appetite, vomiting or fever depends on the cause of cholestasis.

Diagnosis

A doctor tries to determine whether the cause is within or outside the liver on the basis of symptoms and the results of a physical examination. Recent use of drugs that can cause cholestasis suggests a cause within the liver. Small spiders like blood vessels visible in the skin, an enlarged spleen and fluid in the abdominal cavity, which are signs of chronic liver diseases also suggest a cause within the liver.

Findings that suggest a cause outside the liver include certain kinds of abdominal pain and an enlarged gall bladder.

Laboratory Test: - The blood levels of two enzymes alkaline phosphatare and gammaglutamyl transpeptidase are very high in people with cholestasis.

Treatment

Homeopathic Medicine: - Berberis V., Carduus Mar, Chelidonium, China, Hydrastis, Lachesis, Leptandra, Lycopodium, Merc. Sol., Myrica, etc.

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Asthma

ASTHMA

Asthma is a chronic disease of the respiratory system in which the airway occasionally constricts, becomes inflamed, and is lined with excessive amounts of mucus, often in response to one or more triggers.

Pathophysiology

Inflamed airways and bronchoconstriction in asthma, airways narrowed as a result of the inflammatory response cause wheezing.

Bronchoconstriction

During an asthma episode, inflamed airways react to environmental triggers such as smoke, dust, or pollen. The airways narrow and produce excess mucus, making it difficult to breathe. In essence, asthma is the result of an immune response in the bronchial airways.

The airways of asthmatics are “hypersensitive” to certain triggers, also known as stimuli. In response to exposure to these triggers, the bronchi contract into spasm. Inflammation soon follows, leading to a further narrowing of the airways and excessive mucus production, which leads to coughing and other breathing difficulties.

Diagnosis

A Physician can diagnose asthma on the basis of typical findings in a patient’s clinical history and examination. Asthma is strongly suspected if a patient suffers from eczema or other allergic conditions-suggestion a general Atopic Constitution-or has a family history of asthma.

Testing Peak Flow at rest and after exercise can be helpful, especially in young asthmatics that may experience only exercise-include asthma

If the diagnosis is in doubt, a more formal Lung Function Test may be conducted.

Once a diagnosis of asthma is made, a patient can use peak flow meter testing to monitor the severity of the disease.

A Spirometry Test can also measure how well your lungs are functioning but provides more detailed information than peak flow meter.

Less commonly, other tests such as Chest X-rays are done to make sure do not have any other breathing problems. For example; a disease called chronic obstructive pulmonary disease has similar symptoms to asthma.

An Allergy Skin Test may be done to find out whether you are allergic to certain substances.

Signs and Symptom

Some or all of the following symptoms may be present in those with asthma:

i.)                 Dyspnea,

ii.)               Wheezing

iii.)             Stridor

iv.)            Coughing,

v.)              An inability for physical exertion.

vi.)            Some asthmatics that have severe shortness of breath and tightening of the lungs never wheeze or have Stridor and their symptoms may be confused with a COPD-type disease.

Treatment

Asthma cannot be cured. Treatment will aim to reduce the frequency, severity and length of your asthma attacks. Because a lot of different factors are involved in asthma, your treatment plan will be individual to a patient’ itself, combining medicines and asthma management in the way that works best for the patient.

Homeopathic Medicines

Aconite, Bryonia, Arsenic, Blatta orientalis, Boerhaavia diffusa, Calotropis gigantean, Justicia adhatoda, Ocimum sanctum, Gridelia, Ipecacuanha, Passiflora incarnate, Eucalyptus, Lemna Minor, etc.

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Sinusitis

SINUSITIS

Sinusitis is an inflammation of the paranasal sinuses, which may or may not be as a result of infection, from bacterial, fungal, viral, allergic issues.

Newer classifications of sinusitis refer to it as Rhinosinusitis, taking into account the thought that inflammation of the nose as well as Rhinitis.

There are several paired paranasal sinuses, including the Frontal, Ethmoid, Maxillary and sphenoid sinuses.

Acute Sinusitis

 Acute Sinusitis is usually precipitated by an earlier upper respiratory tract infection, generally of viral origin, virally damaged surface tissues are then colonized by bacteria, most commonly Haemophilus Influenza, Streptococcus Pneumoniae, moraxella Cutarrhalis and Staphylococcus aureus.

Another possible cause of Sinusitis can be dental problem that affect the maxillary Sinus.

By Duration- going on less than four weeks.

Chronic Sinusitis

 Chromic Sinusitis is a complicated spectrum of disease that shares Chronic Inflammation of the Sinus.

   The Causes are multifactorial and many include allergy, environmental factors such as dust or pollution, bacterial infection and fungus. Non allergic factors such as Vasomotors Rhinitis can also cause Chronic Sinus Problems.

Diagnosis

Asymmetric growth of tongue plaque happens due to drainage from a fungal sinus infection.

  Allergies, structural problems such as for example a deviated spectrum, small sinus Ostia, smoking, nasal polyps, carrying the cystic fibrosis gene, Priorbouts of Sinusitis as each instance may result in increased inflammation of the nasal or sinus mucosa and potentially further narrow the openings.

Acute Sinusitis often last longer and typically causes more Symptoms than just a cold.

A doctor can diagnose Sinusitis by medical history, Physical examination, X-rays and of necessary MRTS or CT scan.

Treatment

There are many remedies that react well in our homeopathic system. Let us discuss indications of few remedies that follow,

Belladonna, Sanguirium Nitricum, Sanguinaria, Usnea Barbata, Prunus Spinosa, Natrum Mur, Silicea, Allium Cepa, Lemna Minor and Spigelia.

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Respiratory System

RESPIRATORY SYSTEM

In human and other animals, the respiratory system can be conveniently subdivided into an upper respiratory tract and lower respiratory tract, trachea and lungs.

Air moves through the body in the following order:-

i.)                Nostrils

ii.)              Nasal Cavity

iii.)           Pharynx

iv.)            Trachea

v.)              Thoracic Cavity

vi.)            Bronchi

vii.)         Alveoli

Upper Respiratory Tract

The conducting zone begins with the Nares of the nose, which open into the nasopharynx.

Lower Respiratory Tract

The trachea leads down to the thoracic cavity where it divides into the right and the left main stem bronchi.

The Subdivisions of the bronchus are: - Primary, Secondary and Tertiary Divisions. In all, they divide 16 more times into even smaller bronchioles.

The bronchioles lead to the respiratory zone of lungs which consists of respiratory bronchioles, alveolar ducts and alveoli, the multi-labulated sacs in which most of the gas exchange occurs.

Ventilation

Ventilation of the lungs is carried out by the muscles of respiration.

Control

Ventilation occurs under the control of the autonomic nervous system from the part of the brain stem, the medulla oblongata and pons. This area of the brain forms the respiratory regulatory center, a series of interconnected neurons within the lower and middle brain stem which coordinate respiratory movements. The sections are the Pneumotaxic center, the apneustic center and the dorsal and ventral respiratory groups. This section is especially sensitive during infancy and the neurons can be destroyed if the infants is dropped or shaken violently. The result can be death due to shaken baby syndrome.

Inhalation  

Inhalation is initiated by the diaphragm and supported by t external intercostals muscles.  Normal resting respirations are 10 to 18 breaths per minute. Its time period is 2 seconds. During vigorous inhalation (rates exceeding 35 breathes per minute), or in approaching respiratory failure, accessory muscles of respiration are recruited for support. These consist of sternocleidomastoid, Plasma and the strap muscles of the neck.

Exhalation

Exhalation is generally a passive process, however active or forced exhalation is achieved by the abdominal and internal intercostals muscles.

The lungs have a natural elasticity, as they recoil from the stretch of inhalation; air flows back out until the pressure in the chest and the atmosphere reach equilibrium.

Circulation

The right side of the heart pumps blood from the right ventricle through the pulmonary semilunar valve into the pulmonary trunk: the trunk branches into the right and left pulmonary arteries to the pulmonary blood vessels. The vessels generally accompany the airways and also undezgo numerous branching. Once the gas exchange process is complete in the pulmonary capillaries, blood is returned to the left side of the heart through four pulmonary Veins, two from each side. The pulmonary circulation has a very low resistance, due to the short distance within the lungs, compared to the systemic circulation and for this reason, all the pressure within the pulmonary blood vessels are normally low as compared to the pressure of the systemic circulation loop.

Virtually all the body’s blood travels through the lungs every minute. The lungs add and remove many chemicals messengers from the blood as it flows through pulmonary Capillary bed. The fine Capillaries also trap blood clots that have formed in systemic Veins.

Gas Exchange

The major function of the respiratory system in gas exchange is as gas exchange occurs; the acid-base balance of the body is maintained a part of homeostasis of proper ventilation is not maintained two opposing conditions could occur –

i.)                Respiratory Acidosis, a life threatening condition and

ii.)              Respiration Alkalosis.

In an average resting adult, the lungs take up about 250ml of oxygen every minute while excreting about 200ml of carbon dioxide. During an average breathe, an adult will exchange from 500ml to 700ml of air. This average breathe capacity is called tidal volume.

Diseases of the Respiratory System : - Common cold, Rhinitis, Sinusitis, Pharyngitis, Tonsillitis, Laryngitis, Tracheitis, Croup, Epiglottitis, Vasomotor Rhinitis, Hay Fever, Atrophic Rhinitis, Nasal Polyp, Adenoid Hypertrophy, Peritonsillar Abscess, Vocal Fold Nodule, Laryngospasm, Influenza, Pneumonia, Bronchitis, Emphysema, COPD, Asthma, Status Asthmaticus, Brochiectasis, Pneumonitis, Pulmonary Edema, Interstitial lung disease, lung abscess, Pleura Effusion, Empyema, Pneumothorax, Homeothorax, Hemopneumothorax, medelson’s Syndrome, Respiratory Failure, Atelectasis, Mediastinal Emphysema, Mediastinitis, etc.    

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