FitSugar

STIs Explained: Gonorrhea

FitSugar — Tue, 01 May 2007 17:15:00 -0700

Warm weather has arrived and since Spring Fever is in the air, I thought I'd take the time to talk about Sexually Transmitted Infections (STIs). Fun stuff, I know.

STI stands for "sexually transmitted infection." The reason this term is used instead of STDs (sexually transmitted disease) is because the word "infection" is more accurate since many of these are actually curable (except for Genital Herpes, Genital Warts, and HIV). Also, the word "infection" carries less of a negative social stigma than the word "disease."

STIs like Gonorrhea and Chlamydia are 100% avoidable. Abstaining from sex altogether is the surest way to keep yourself STI-free, but since that's not realistic, definitely have you and your partner get tested before you have sex.

Gonorrhea is spread through contact with the penis, vagina, mouth, or anus, so being in a mutually monogamous relationship with someone you know is uninfected is also a great way to keep yourself safe. When latex or polyurethane condoms are used consistently and correctly, that can also reduce the risk of transmitting gonorrhea.

Make sure to see your gynecologist annually to get tested, because if left untreated, gonorrhea can cause pelvic inflammatory disease (PID) or arthritis.

Want to know about Gonorrhea? Then read more

STI	Symptoms	How do you test for it?	Treatment
Gonorrhea (The #2 STI in the U.S.)	Frequently asymptomatic (no symptoms) Discharge from vagina, penis, or rectum Burning or itching during urination Sore throat	Samples of the infected fluid or urine must be taken	Since gonorrhea is a bacterial infection, several antibiotics can successfully cure it. However, drug-resistant strains of gonorrhea are increasing in many areas of the world, including the United States.

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STIs Explained: Chlamydia

FitSugar — Fri, 27 Apr 2007 13:30:00 -0700

Since Spring has arrived and romance is in the air, I thought I'd take the time to talk about Sexually Transmitted Infections (STIs). Not your favorite topic, I know, but definitely worth knowing about.

STI stands for "sexually transmitted infection." The reason this term is used instead of STD (sexually transmitted disease) is because the word "infection" is more accurate since many are actually curable (except for Genital Herpes and Genital Warts). Also, the word "infection" carries less of a negative social stigma than the word "disease."

STIs like chlamydia are 100% preventable, so you can either abstain from sex altogether (not realistic), or have you and your partner get tested before you have sex. Chlamydia can be passed through regular sex, and anal and oral sex, so being in a mutually monogamous relationship with someone you know who is uninfected is also a great way to keep yourself safe. When latex or polyurethane condoms are used consistently and correctly, that can also reduce the risk of transmitting chlamydia.

Make sure you see your gynecologist annually to get tested because if chlamydia goes untreated, irreversible damage can occur to a woman's reproductive organs, causing infertility.

Want to know about chlamydia? Then read more

STI	Symptoms	How do you test for it?	Treatment
Chlamydia (The #1 STI in the U.S.)	Frequently asymptomatic (no symptoms) Vaginal or penile discharge Burning during urination Women may experience lower abdominal pain, pain during intercourse, and irregular bleeding between periods Men may experience pain or swelling in the testicles	Samples of the infected fluid must be taken. Urine tests are now available too (which is good news for guys) but because they're more expensive, they're not yet available at all health clinics.	Since Chlamydia is a bacterial infection, antibiotics taken orally can cure most infections, but another round of antibiotics might need to be taken to get rid of it completely.

STI

Symptoms

How do you test for it?

Treatment

Chlamydia (The #1 STI in the U.S.)

Frequently asymptomatic (no symptoms)
Vaginal or penile discharge
Burning during urination
Women may experience lower abdominal pain, pain during intercourse, and irregular bleeding between periods
Men may experience pain or swelling in the testicles

Samples of the infected fluid must be taken.

Urine tests are now available too (which is good news for guys) but because they're more expensive, they're not yet available at all health clinics.

Since Chlamydia is a bacterial infection, antibiotics taken orally can cure most infections, but another round of antibiotics might need to be taken to get rid of it completely.

Source

Gonorrhea

admin — Thu, 04 Sep 2008 19:20:42 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Gonorrhea is a sexually transmitted disease (commonly known as "the clap") caused by the bacterium Neisseria gonorrhea.

Alternative Names

Clap

Causes, incidence, and risk factors

Gonorrhea is one of the most common infectious diseases. Anyone who has any type of sex can catch gonorrhea. The infection can be spread through the mouth, vagina, penis, or anus.

The bacteria grow in warm, moist areas of the body, including the tubes that carry urine out of the body (urethra). In women, the bacteria may be found in the fallopian tubes, uterus, and cervix. The bacteria can even grow in the eyes.

Every state in the United States requires that health care providers tell their State Board of Health about any diagnosed cases of gonorrhea. This is done to make sure the patient gets proper follow up care and that anyone who had sexual contact with the patient is found and tested.

More than 700,000 persons in the United States get gonorrhea every year, according to the Centers for Disease Control and Prevention (CDC). In general, gonorrhea is most common in people 20 to 24 years old.

Gonorrhea is more common in large cities, inner-city areas, populations with lower overall levels of education and people with lower socioeconomic status.

Risk factors include having multiple sexual partners, having a partner with a past history of any sexually transmitted disease, and having sex without using a condom.

Symptoms

Symptoms of gonorrhea usually appear 2 - 5 days after infection, however, in men, symptoms may take up to a month to appear. Some people do not have symptoms. They may be completely unaware that they have caught the disease, and therefore do not seek treatment. This increases the risk of complications and the chances of passing the infection on to another person.

Symptoms in men include:

Burning and pain while urinating
Increased urinary frequency or urgency
Discharge from the penis (white, yellow, or green in color)
Red or swollen opening of penis (urethra)
Tender or swollen testicles
Sore throat

Symptoms in women can be very mild or non-specific, and may be mistaken for another type of infection. They include:

Vaginal discharge
Burning and pain while urinating
Increased urination
Sore throat
Painful sexual intercourse
Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and stomach area)
Fever (if the infection spreads to the fallopian tubes and stomach area)

Signs and tests

Tests used to diagnose gonorrhea in women include:

Cervical gram stain
Endocervical culture for gonorrhea

Tests used to diagnose gonorrhea in men include:

Gram stain of urethral discharge
Urethral discharge culture for gonorrhea

Tests used to diagnose gonorrhea in both men and women:

Throat swab culture
Rectal culture
Ligase chain reaction (LCR) test

Gonorrhea can be quickly identified by staining a sample of tissue or discharge from the infected and then looking at it under the microscope. This is called a gram stain. Although this method is the fastest, it is not the most certain.

Cultures (cells that grow in a lab dish) provide absolute proof of infection. Generally, samples for a culture are taken from the cervix, vagina, urethra, anus, or throat. Cultures can provide a preliminary diagnosis often within 24 hours and a confirmed diagnosis within 72 hours.

DNA tests for the gonorrhea have been developed. They are especially useful as a screening test because they are quicker than cultures. Such tests can also be performed on urine samples, which are a lot easier to collect than samples from the genital area.

Treatment

There are two goals in treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infection in the patient. The second is to locate and test all of the other people the person had sexual contact with and treat them to prevent further spread of the disease.

Penicillin used to be given to patients with gonorrhea. But it is not often used anymore because some types of the gonorrhea bacteria no longer respond to the drug. This is called antibiotic resistance. Antibiotic resistance is major public health threat in which bacteria cannot be killed with the usual antibiotic medicines.

The bacteria responsible for gonorrhea is growing increasingly resistant to another class of antibiotics called fluoroquinolones, which includes ciprofloxacin, ofloxacin, or levofloxacin. The U.S. Centers for Disease Control and Prevention now recommendeds against using these medicines to treat gonorrhea.

Antibiotics called cephalosporins, including Ceftriaxone (Rocephin), are recommended for persons with gonorrhea. A medicine called Azithromycin (Zithromax) may be given to persons with uncomplicated infections.

A follow-up visit 7 days after treatment is important, especially for women who may not have symptoms associated with the infection.

Expectations (prognosis)

Immediately treating a gonorrhea infection helps prevent permanent scarring and infertility. When treatment is delayed there is a greater chance of complications and sterility.

Complications

Complications in women may include:

Salpingitis (scarring of the fallopian tubes), which can lead to problems getting pregnant
Pelvic inflammatory disease
Vulvovaginitis
Sterility (inability to become pregnant)
Painful intercourse (dyspareunia)

Complications in men may include:

Periurethral abscess (collection of pus around the urethra)
Narrowing of the urethra caused by scarring (urethral stricture)
Urination problems
Urinary tract infection
Kidney failure

Complications in both men and women may include:

Disseminated infection, which can be very serious
Infection or inflammation of the reproductive system
Peritonitis
Bacteremia (gonococcemia)
Gonococcal arthritis (joint infection)
Gonococcal pharyngitis (throat infection)
Ophthalmia neonatorum (gonococcal conjunctivitis)

Calling your health care provider

If you have symptoms suggestive of gonorrhea, you should call your health care provider immediately. Most state-sponsored clinics will diagnose and treat sexually transmitted diseases (STDs) without charge.

Prevention

Not having sexual intercourse (abstinence) is the only absolute method of preventing gonorrhea. A monogamous sexual relationship with an individual known to be free of any STD can reduce risk. Monogamous means you and your partner do not have sex with any other persons.

You can greatly lower your risk of catching an STD by using a condom every time you have sex. Condoms are available for both men and women, but are most commonly worn by the man. A condom must be used properly every time. (For instructions on how to use a condom, see safe sex.)

To further prevent the spread of infection, treatment of all sexual partners is important.

Gonorrhea is often associated with the presence of other sexually transmitted diseases. About half of the women with gonorrhea are also infected with chlamydia, another very common STD that can result in sterility. If you have gonorrhea, you should request testing for other sexually transmitted diseases, including AIDS.

References

Centers for Disease Control and Prevention (CDC). Update to CDC's Sexually Transmitted Diseases Treatment Guidelines, 2006: Fluoroquinolones No Longer Recommended for Treatment of Gonococcal Infections. MMWR. 2007; 56(14);332-336.

U.S. Preventive Services Task Force. Screening for Gonorrhea: Recommendation Statement. Am Fam Physician. Nov. 1, 2005; 72(9); 1783-1786.

Cohen J, Powderly WG. Infectious Diseases. 2nd ed. New York, NY: Elsevier; 2004:2173-2186.

Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2004. Atlanta, GA: U.S. Department of Health and Human Service, September 2005.

Weinstock H, Berman S, Cates W. Sexually transmitted disease among American youth: Incidence and prevalence estimates, 2000. Perspect Sex Reprod Health. 2004; 36: 6-10.

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines 2002. MMWR. 2002;51(no. RR-6).

Review Date: 4/12/2007

Reviewed By: Updated by: A.D.A.M. Editorial Team: Greg Juhn, M.T.P.W., David R. Eltz, Kelli A. Stacy. Previously reviewed by Monica Gandhi MD, MPH, Assistant Professor, Division of Infectious Diseases, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. (July 2006)

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

A.D.A.M. Copyright

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

Source Doc: 1_007267

More Popular Than Gonorrhea?

FitSugar — Mon, 11 Jun 2007 17:15:00 -0700

I just read about a relatively new STI that I've never heard of, known as Mycoplasma genitalium. It was first discovered in the 1980's and is now becoming more prevalent that Gonorrhea! I just read about it on That's Fit and thought I should share some of the details with you.

Mycoplasma genitalium is one of the tiniest free-living organisms, and it can cause a number of common diseases.

It can cause respiratory infections, as well as inflammation of the urethra in men, and inflammation of the cervix and the lining of the uterus in women, possibly leading to infertility. You may notice cloudy discharge when urinating, stinging, or burning. However, many people are symptom-free.

It can be passed just like other STIs - when an infected person's bodily fluids like blood, semen, or vaginal fluid comes in contact with the mucus membrane of an uninfected person.

If you suspect you have this infection, see your doctor right away. They can take a swab of the infected area, test it, and prescribe antibiotics to treat it if necessary.

Fit's Tips: Since this is an STI, being in a mutually monogamous relationship with someone you know is uninfected is a great way to keep yourself safe. Also, when latex or polyurethane condoms are used consistently and correctly, that can also reduce the risk of transmitting Mycoplasma genitalium.

Source

Gonococcemia - disseminated

admin — Wed, 03 Sep 2008 17:51:07 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention
References

Illustrations

Circulatory system

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Disseminated gonococcemia is a sexually-transmitted disease caused by the bacteria Neisseria gonorrhoeae.

Alternative Names

Gonococcal bacteremia

Causes, incidence, and risk factors

Gonorrhea is one of the most common infectious diseases. Anyone who has any type of sex can catch gonorrhea. The infection can be spread through the mouth, vagina, penis, or anus.

Disseminated gonococcemia can be very serious. It generally develops about several days to 2 weeks after the primary gonorrhea infection. The infection spreads through the bloodstream to other parts of the body. An infected woman may spread the infection to her newborn during childbirth.

The disease is more common in large cities, inner-city areas, populations with lower overall levels of education, and people with lower socioeconomic status.

Risk factors include having multiple sexual partners, having a partner with a past history of any sexually transmitted disease, and having sex without using a condom.

Symptoms

Chills
Fever
General ill feeling (malaise)
Joint pain
Joint swelling
Painful tendons of wrists or heels
Skin rash -- flat, pink-to-red spots turn into raised, pus-filled bumps

The combination of skin rash and aching, swollen tendons is sometimes known as tenosynovitis-dermatitis syndrome.

Signs and tests

Gonorrhea is often associated with the presence of other sexually transmitted diseases. About half of women with gonorrhea are also infected with chlamydia, another very common STD that can result in sterility. If you have gonorrhea, you should request testing for other sexually transmitted diseases, including AIDS.

Cultures (cells that grow in a lab dish) provide absolute proof of a gonorrhea infection. Generally, samples for a culture are taken from the cervix, vagina, urethra, anus, or throat. Cultures can provide a preliminary diagnosis often within 24 hours and a confirmed diagnosis within 72 hours.

See:

Treatment

Gonorrhea is now treated with potent antibiotics called cephalosporins, including ceftriaxone (Rocephin). For gonococcemia, treatment is usually first given through an IV rather than by mouth. Since chlamydia frequently occurs along with gonorrhea, treatment for chlamydia is often given at the same time.

A follow-up visit after treatment is important to recheck lab tests and make sure the infection is cured.

Expectations (prognosis)

With proper treatment, the outcome is expected to be good. When treatment is delayed there is a greater chance of complications.

Complications

Gonococcal endocarditis
Gonococcal meningitis

Calling your health care provider

Call your health care provider if you have symptoms of disseminated gonococcemia.

Prevention

Abstinence is the only sure prevention. Other prevention consists of following safer sexual practices. Monogamous sexual relations with a known disease-free partner is one good means of prevention.

Latex condoms protect against gonorrhea and other sexually transmitted diseases when the status of a partner is unknown.

Treatment of all sexual partners of a known infected person is essential to prevent further spread or reinfection.

References

U.S. Preventive Services Task Force. Screening for Gonorrhea: Recommendation Statement. Am Fam Physician. Nov. 1, 2005; 72(9); 1783-1786.

Cohen J, Powderly WG. Infectious Diseases. 2nd ed. New York, NY: Elsevier; 2004:2173-2186.

Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2004. Atlanta, GA: U.S. Department of Health and Human Service, September 2005.

Weinstock H, Berman S, Cates W. Sexually transmitted disease among American youth: Incidence and prevalence estimates, 2000. Perspect Sex Reprod Health. 2004; 36: 6-10.

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines 2002. MMWR. 2002;51(no. RR-6).

Review Date: 6/22/2007

Reviewed By: Cyrus Badshah, M.D., Ph.D., Assistant Professor of Clinical Medicine, College of Physicians and Surgeons, Columbia University; Assistant Attending Physician, Department of Medicine, Division of Infectious Diseases & Medical Director, Chest (TB)Clinic and Directly Observed Therapy Program, Harlem Hospital Center. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Source Doc: 1_000645

Gonococcal arthritis

admin — Wed, 03 Sep 2008 17:49:52 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention
References

Illustrations

Gonoccocal arthritis

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Gonococcal arthritis is inflammation of a joint (usually just one) due to a gonorrhea infection.

Alternative Names

Disseminated gonococcal infection (DGI)

Causes, incidence, and risk factors

Gonococcal arthritis is a bacterial infection of a joint. It occurs in people who have gonorrhea. It affects women four times more often than men, and is most common among sexually active adolescent girls.

Two forms of gonococcal arthritis exist:

One involves skin rashes and multiple joints, usually large joints such as the knee, wrist, and ankle
The second, less common form involves disseminated gonococcemia, which leads to infection of a single joint

Symptoms

Fever
Lower abdominal pain
Migrating joint pain for 1 to 4 days
Pain in the hands or wrists due to tendon inflammation
Pain or burning on urination
Single joint pain
Skin rash (lesions are flat, pink to red, may later contain pus or appear purple)

Signs and tests

Blood cultures should be checked in all cases of possible gonococcal arthritis.

Tests will be done to check for a gonorrhea infection. This may involve taking samples of tissue, stool, joint fluids, or other body material and sending them to a lab for examination under a microscope. Examples of such tests include:

Treatment

The gonorrhea infection must be treated. For detailed information about treating this disease, see gonorrhea.

There are two aspects of treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infected person. The second is to locate, test, and treat all sexual contacts of the infected person to prevent further spread of the disease.

A new standardized treatment routine is recommended by the Centers for Disease Control and Prevention (CDC). Your health care provider will determine the best and most up-to-date treatment. A follow-up visit 7 days after treatment is important to recheck blood tests and confirm the cure of infection.

Expectations (prognosis)

Symptoms usually improve within 1 to 2 days of starting treatment. Full recovery can be expected.

Complications

Untreated, this condition may lead to persistent joint pain.

For information on other gonorrhea-related complications, see gonorrhea.

Calling your health care provider

Call your health care provider if you have symptoms of gonococcal arthritis.

Prevention

Not having sexual intercourse (abstinence) is the only absolute method of preventing gonorrhea. A monogamous sexual relationship with an individual known to be free of any sexually transmitted disease (STD) can reduce risk. Monogamous means you and your partner do not have sex with any other persons.

References

Centers for Disease Control and Prevention (CDC). Update to CDC's sexually transmitted diseases treatment guidelines, 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. MMWR. 2007;56(14):332-336.

U.S. Preventive Services Task Force. Screening for gonorrhea: recommendation statement. Ann Fam Physician. 2005;3(3):263-267.

Cohen J, Powderly WG. Infectious Diseases. 2nd ed. New York, NY: Elsevier; 2004:2173-2186.

Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2004. Atlanta, GA: U.S. Department of Health and Human Service, September 2005.

Weinstock H, Berman S, Cates W. Sexually transmitted disease among American youth: Incidence and prevalence estimates, 2000. Perspect Sex Reprod Health. 2004;36:6-10.

Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2002. MMWR. 2002;51(no. RR-6):1-78.

Review Date: 12/3/2007

Reviewed By: D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

adam.com

Source Doc: 1_000453

Pharyngitis - gonococcal

admin — Wed, 03 Sep 2008 17:50:50 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention
References

Illustrations

Throat anatomy

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Gonococcal pharyngitis is a sexually transmitted infection of the tonsils and back of the throat (pharynx).

Alternative Names

Gonococcal pharyngitis

Causes, incidence, and risk factors

Gonococcal pharyngitis is caused by Neisseria gonorrhoeae bacteria. The bacteria spreads through oral sex with an infected partner. Most of these throat infections produce no symptoms (asymptomatic).

When there is discomfort, it is usually mild. There aren't any symptoms in the rest of the body unless the person develops disseminated gonococcemia, where the infection spreads throughout the body through the bloodstream.

This disease is most common in men who have sex with men. Risk factors include recent exposure to gonorrhea, sexual activity with multiple partners, and performing oral sex.

Symptoms

Difficulty swallowing
Fever
Sore throat
Tender, swollen lymph nodes in the neck

Additional symptoms that may be associated with this disease:

Abnormal sense of taste
Headache
Joint stiffness
Muscle pain
Nasal congestion
Nasal discharge
Neck pain

Note: There may be no symptoms.

Signs and tests

A throat swab culture is positive for gonococcus bacteria. Regular strep throat testing will not pick up gonorrhea. If you think you might have gonococcal pharyngitis, you should tell your health care provider. Telling your provider means they will ask for a special test to see if you have this disease.

Treatment

There are two parts to successfully treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infected person. The second is to locate, test, and treat all of that person's sexual contacts to prevent further spread of the disease.

Mandatory reporting of gonococcal disease has been instituted and has kept the number of cases of gonorrhea at a low level. However, the number of cases is rising, especially among men who have sex with men in large urban centers.

The bacteria that causes this disease has become resistant to certain drugs. Today, ceftriaxone injected into a muscle is the only antibiotic used to treat gonococcal pharyngitis.

People who are allergic to penicillin and cephalosporin may be prescribed azithromycin, which is taken by mouth.

In addition to treatment for gonorrhea, people are usually treated at the same time for chlamydia. Chlamydia often causes infection at the same time as gonorrhea, but it can be harder to diagnose.

Expectations (prognosis)

Gonorrhea can be completely and quickly cured when diagnosed early and treated promptly before complications develop. Untreated gonorrhea may spread to other parts of the body, causing inflammation of the testes or prostate in men, or pelvic inflammatory disease in women.

Complications

The following complications may occur in both men and women:

Disseminated gonococcemia
Gonococcal arthritis

Complications in men may include:

Epididymitis
Orchitis
Prostatitis
Urethral scarring and stricture

Complications in women may include:

Increased chances of ectopic pregnancy
Infertility
Perihepatitis
Pelvic inflammatory disease
Salpingitis
Sterility

Calling your health care provider

Call your health care provider if you know or suspect that your sexual partner may be infected.

Call your health care provider if you develop symptoms of gonococcal pharyngitis.

Prevention

Sexual abstinence is the only sure way to avoid gonorrhea, but this is often neither practical nor reasonable. Safer sex behaviors can reduce your risk. The use of condoms, both male and female types, decreases the likelihood of contracting a sexually transmitted disease -- but they must be used properly.

The condom should be in place from the beginning to end of sexual activity, and should be used EVERY time the person engages in sexual activity -- including oral sex -- with a non-monogamous partner or possibly infected partner.

Treatment of all sexual partners is essential to prevent re-infection.

References

Handsfield HH, Sparling PF. Neisseria gonorrhoeae. In: Cohen J, Powderly WG, Berkley SF, Calandra T, Clumeck N, Finch RG, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, PA; Churchill Livingstone Elsevier; 2005: chap 209.

Review Date: 5/19/2008

Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Maternal & Child Health Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

adam.com

Source Doc: 1_000601

Neonatal conjunctivitis

admin — Thu, 04 Sep 2008 18:48:22 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Neonatal conjunctivitis is a red eye in a newborn caused by irritation, a blocked tear duct, or infection.

Alternative Names

Newborn conjunctivitis; Conjunctivitis of the newborn; Ophthalmia neonatorum

Causes, incidence, and risk factors

Conjunctivitis in a newborn may be caused by a blocked tear duct, irritation produced by the antibiotic eyedrops given at birth, or infection. Neonate conjunctivitis that is caused by an infection can be very serious.

Many organisms can cause infection in the eyes of newborn infants. The most common bacterial infections with that can cause serious eye damage are gonorrhea (Neisseria gonorrhea) and chlamydia (Chlamydia trachomatis), which can be passed from mother to child during birth.

The viruses that cause genital and oral herpes can also cause neonatal conjunctivitis and severe eye damage. Such viruses may also be passed to the baby during childbirth. However, herpes conjunctivitis is less common than conjunctivitis caused by gonorrhea and chlamydia.

Bacteria that normally live in a woman's vagina, which are not sexually transmitted, can also cause neonatal conjunctivitis.

The mother may be without symptoms (asymptomatic ) at the time of delivery, yet still carry bacteria or viruses that can cause conjunctivitis in the newborn. Infected newborn infants develop drainage from the eyes within 1 day to 2 weeks after birth. The eyelids become puffy, red, and tender.

Because of the significance of neonatal conjunctivitis, all hospitals (most required by state law) routinely use silver nitrate or antibiotic drops, such as erythromycin, in a newborn's eyes to prevent disease. Silver nitrate is no longer commonly used, and has been mostly replaced by antibiotic eye drops.

Symptoms

Watery, bloody drainage from the infant's eyes
Thick pus-like drainage from the infant's eyes
Swollen, red eyelids

Signs and tests

Standard ophthalmologic examination
Slit-lamp examination to look for corneal ulceration, perforation, or other changes (called iridocyclitis and inclusion blennorrhea)
Culture of the drainage from the eye to look for Neisseria gonorrhea and Chlamydia trachomatis

Treatment

Topical antibiotic eye drops and ointments, oral antibiotics, and intravenous antibiotics are all used depending on the severity of the infection and the organism responsible for it.

Occasionally, topical and oral (or topical and intravenous) routes may be used simultaneously. Irrigation of the eye with normal saline is done to remove the purulent drainage that accumulates.

If the conjunctivitis is caused by a blocked tear duct, gentle warm massage between the eye and nasal area may help. If it is not cleared by one year of age, surgery may be required.

Eye irritation caused by the eye drops given at birth should resolve on its own.

Expectations (prognosis)

Early recognition of infected mothers and good hospital preventive practices have reduced conjunctivitis of the newborn to very low levels. Infants who do develop conjunctivitis and are quickly treated generally have good outcomes.

Complications

Blindness
Corneal scarring
Inflammation of the iris
Perforation of the cornea
Pneumonia

Calling your health care provider

Talk to your health care provider if you have given birth (or expect to give birth) to a baby in a setting where antibiotic or silver nitrate drops are not routinely placed in the infant's eyes -- for example, an unsupervised birth at home. This is especially important if you have had, or are at risk for, any sexually-transmitted disease.

Prevention

Treatment of a pregnant woman for sexually-transmitted diseases will prevent conjunctivitis in the neonate. Even if the mother's infection has not been recognized, prophylactic eye drops put into the infant's eyes immediately after birth help prevent many infections, and these drops are used routinely for all births.

A cesarean section is recommended when the mother has active herpes lesions at the time of delivery. Antibiotics, given intravenously, may be given to infants of mothers with untreated gonorrhea. However, antibiotic eye drops may not prevent chlamydial conjunctivitis.

Review Date: 10/15/2007

Reviewed By: Deirdre O’Reilly, MD, MPH, Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts. Review Provided by VeriMed Healthcare Network.

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Source Doc: 1_001606

Chlamydial urethritis - male

admin — Wed, 03 Sep 2008 17:51:11 -0700

Overview

Definition
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention
References

Illustrations

Male reproductive anatomy

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Chlamydial urethritis is a sexually transmitted disease involving infection of the urethra (the tube that drains urine from the bladder).

Causes, incidence, and risk factors

Chlamydial urethritis is caused by the bacteria Chlamydia trachomatis.

Chlamydia can cause a type of swelling (inflammation) of the urethra ( urethritis). Chlamydia and gonorrhea often occur together.

People who are sexually active and those with multiple sexual partners are at highest risk for chlamydia infection.

Different strains of chlamydia cause genital, eye, lymph node, and respiratory infections. A child born to a woman with a chlamydia infection of the cervix may develop an eye or lung infection.

Symptoms

Difficulty urinating
- Painful urination
- Burning sensation during urination
Discharge from the penis
Redness, swelling, itching of the opening of the urethra at tip of the penis
Swelling and tenderness of the testicles

The symptoms can appear similar to those of infection with gonorrhea, but continue even after after treatment for gonorrhea.

Signs and tests

Taking a sample of secretions from the penis and sending it to a lab for a culture or a test called polymerase chain reaction (PCR)
Urethral discharge culture or genital fluid testing for gonorrhea
Urine test

Treatment

Chlamydia can be treated with a variety of antibiotics, including:

Azithromycin
Erythromycin
Quinolones
Tetracyclines

Both sexual partners must be treated for both gonorrhea and chlamydia to prevent passing the infections back and forth. Even partners without symptoms need to be treated.

Expectations (prognosis)

Antibiotic treatment is usually successful.

Complications

Narrowing (strictures) of the urethra may occur. This may require surgery to correct.

The infection may come back (recur) if you do not take your medicine as directed, or if your sexual partners are not treated.

Calling your health care provider

Call your health care provider if you have symptoms of a chlamydia infection.

Prevention

Screening for other sexually transmitted infections, including syphilis and HIV, is important when you've been diagnosed with a new chlamydia infection.

Having a sexual relationship with one partner (monogamous) who is not infected is one way to avoid chlamydia. The proper use of condoms during intercourse usually prevents infection.

References

Centers for Disease Control and Prevention. Workowski KA, Berman SM. Diseases characterized by urethritis and cervicitis. Sexually transmitted diseases treatment guidelines 2006. MMWR Morb Mortal Wkly Rep. 2006;55:35-49.

Review Date: 5/5/2008

Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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Source Doc: 1_000659

Proctitis

FitSugar — Wed, 08 Oct 2008 17:35:32 -0700

Overview

Signs and Symptoms
Causes
Risk Factors
Preventive Care
Treatment
Other Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Proctitis is an inflammation of the lining of the rectum causing pain, soreness, bleeding, and a discharge of mucus or pus. Proctitis can last a long or a short amount of time. When the inflammation extends beyond the rectum, the condition is often referred to as proctocolitis. Sometimes it is necessary to treat proctitis the same way as inflammatory bowel disease -- a related disorder characterized by an inflammation of the lining of other parts of the gastrointestinal tract -- is treated.

Signs and Symptoms

Common symptoms of proctitis include:

Anal or rectal pain and discomfort, such as itching
Urgent desire to defecate
Discharge of mucus, pus, or blood
Change in bowel habits, such as constipation or diarrhea
Rectal bleeding
Fever

Causes

Proctitis has both infectious and noninfectious causes. Some infections that cause proctitis include:

Campylobacter
Entamoeba histolytica
Salmonella

Other infections that cause proctitis may be sexually transmitted, such as:

Herpes simplex
Gonorrhea
Chlamydia
Syphilis
Shigella

In addition to these infectious causes, some antibiotic medications used to treat an unrelated infection may actually cause proctitis. While antibiotics selectively inhibit the growth of particular bacteria in the bowel, other microorganisms can withstand the antibiotics, multiply, and cause infection.

Trauma and radiation therapy for cancer of the pelvis or lower abdomen are examples of noninfectious causes of proctitis.

Risk Factors

The following are associated with a high risk of proctitis:

Oral-anal intercourse, particularly with multiple partners
Compromised immune system
Radiation therapy to the lower abdominal or pelvic region
Use of antibiotic medication

Because some people with proctitis also develop inflammatory bowel disease, and related conditions such as Crohn's disease and ulcerative colitis, the risk factors in those instances of proctitis may be similar to the risk factors for inflammatory bowel disease (a family history of inflammatory bowel disease or Jewish ancestry).

Preventive Care

Several steps can be taken to prevent the development of proctitis:

Avoiding anal intercourse may prevent proctitis from being spread by sexual transmission.
A reduction in caffeine, dairy foods, high-fat foods, and artificial sweeteners may lower the risk of proctitis. Studies suggest a link between ulcerative colitis and diets high in these foods.
Stress-reduction techniques such as yoga, tai chi, and deep relaxation, may also lower the risk of proctitis. Studies have shown that stressful situations may induce an inflammation of the lining of the intestines, possibly leading to inflammatory bowel disease.

Treatment

Proctitis is a condition that tends to respond very effectively to a combination of both conventional and complementary therapies. Given the potential for complications from surgery, nonsurgical therapy is preferred for the treatment of proctitis. The specific treatment, however, depends on the cause of proctitis. For example, a doctor may prescribe antibiotics for proctitis caused by bacterial infection. If the inflammation is caused by Crohn's disease or ulcerative colitis, the doctor may recommend corticosteroids or enemas containing non-steroidal anti-inflammatory medication. In addition to these conventional treatments, acupuncture, herbs, and nutritional supplements may also relieve the symptoms of proctitis.

Medications

Antibiotic medication, prescribed by a doctor, effectively treats proctitis caused by the following bacterial infections:

Herpes simplex
Gonorrhea
Chlamydia

When the cause of proctitis is unknown, or when proctitis is caused by radiation therapy, the following drug therapies may be more effective:

Corticosteroids, such as hydrocortisone cream, applied directly to the area
Anti-inflammatory drugs, particularly those used to treat inflammatory bowel disease (such as sulfasalazine and mesalamine), administered orally or as a foam, enema, or suppository

Surgery and Other Procedures

Some symptoms of proctitis, including dilation of the blood vessels on the surface of the inner lining of the rectum or colon, may be treated by a procedure called endoscopic cauterization. Most researchers agree, however, that more aggressive surgery should only be considered when less invasive treatments have proved ineffective.

Nutrition and Dietary Supplements

A comprehensive treatment plan for proctitis may include a range of complementary and alternative therapies. Ask your team of health care providers about the best ways to incorporate these therapies into your overall treatment plan. Always tell your health care provider about the herbs and supplements you are using or considering using.

Following these nutritional tips may help reduce symptoms:

Try to eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell peppers).
Talk to your doctor about the possibility of increasing the level of soluble fiber in your diet through foods such as apples, steel cut oats, and flax seeds. This may help to stimulate easier more solid bowel movements. You should use caution with insoluble fiber (such as Metamucil or psyllium husks), as it can potentially be irritating. Proctitis patients should not use fiber medicinally, even dietary fiber, without first consulting a physician.
Eat foods high in B-vitamins, calcium, and magnesium, such as almonds, beans, whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.
Avoid refined foods such as white breads, pastas, and especially sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
Use healthy oils in foods, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of filtered water daily.
Exercise at least 30 minutes daily, 5 days a week.

Nutritional deficiencies may be addressed with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins and trace minerals, such as magnesium, calcium, folic acid, zinc, and selenium.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil one to two times daily, to help decrease inflammation and improve immunity. Cold-water fish, such as salmon or halibut, are good sources.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.
Grapefruit seed extract (Citrus paradisi), 100 mg capsule or 5 - 10 drops (in favorite beverage) three times daily, for antibacterial or antifungal activity and immunity.
Vitamin C, 500 - 1,000 mg one to three times daily, as an antioxidant, and for immune support.
L-glutamine, 500 - 1,000 mg three times daily, for support of gastrointestinal health and immunity.
Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Garlic (Allium sativum), standardized extract, 400 mg two to three times daily, for antibacterial or antifungal and immune activity.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for inflammation and antibacterial or antifungal activity.
Olive leaf (Olea europaea) standardized extract, 250 - 500 mg one to three times daily, for anticancer and immune effects.
Boswellia (Boswellia serrata) standardized extract, 200 - 400 mg three times daily, for inflammation and gastrointestinal health.

Homeopathy

While no scientific studies have examined the use of homeopathy to prevent or treat proctitis, professional homeopaths may recommend the following remedies for people with symptoms of the disease:

Gambogia -- used to reduce inflammation of the colon and rectum as well as severe bouts of diarrhea. This remedy is particularly useful for those who are extremely fatigued after loose bowel movements.
Natrumsulphuricum -- used to reduce diarrhea, flatulence, and inflammation of the colon and rectum caused primarily by gonorrhea
Sulphur -- used to reduce inflammation of the colon and rectum as well as the itching, burning sensation in the rectum caused by diarrhea

Homeopathic creams for problems in the anal area, such as itching and dryness, may be helpful in relieving symptoms associated with proctitis. Ask your health care provider for more information.

Acupuncture

One promising study of 44 patients with proctitis caused by radiation therapy found that acupuncture "cured" 73% of the patients, "markedly" relieved symptoms in 9% of the patients, and reduced symptoms to "moderate" in 18% of the patients. There were no patients whose symptoms worsened or remained the same following acupuncture treatment.

Mind-Body Medicine

Although research suggests that stress may be associated with an inflammation of the bowel, scientists have yet to determine whether specific personality types are linked to inflammatory bowel disease. Based on clinical experience, however, some psychiatrists report that inflammatory bowel diseases may be associated with anxiety, anger, aggression, obsession, and a tendency to keep emotions bottled up inside. For these reasons, some researchers suggest that psychotherapy combined with the following stress-reduction techniques may help relieve the symptoms of proctitis:

Biofeedback
Hypnotherapy

Other Considerations

An individual with proctitis should keep the following considerations in mind:

Prognosis and Complications

Complications from proctitis can range from the formation of ulcers and boils to severe bleeding. Proctitis related to ulcerative colitis may even evolve to include more widespread areas of the colon and other parts of the gastrointestinal tract.

Mild forms of proctitis, which often resolve spontaneously or with the application of topical creams and foams, will not require long-term medication. People with more severe forms of proctitis, such as proctitis caused by gonorrhea, are often less responsive to treatment with the failure rate being as high as 35% in some cases. In general, however, the prognosis for individuals with most forms of proctitis is good with proper treatment and follow-up with a health care provider.

Supporting Research

Almallah YZ, Ewen SW, El-Tahir A, et al. Distal proctocolitis and n-3 polyunsaturated fatty acids (n-3 PUFAs): the mucosal effect in situ.J Clin Immunol. 2000;20(1):68-76.

Ammon HP. Boswellic acids in chronic inflammatory diseases. Planta Med. 2006 Sep;72(12):1100-16.

Anton PA. Stress and mind-body impact on the course of inflammatory bowel diseases. Semin Gastrointest Dis. 1999;10(1):14-19.

Bartelsman JF, Tytgat GN. Extra-ordinary forms of proctitis. Neth J Med. 1990;37(suppl 1):S52-S56.

Bast A, Haenen GR. Lipoic acid: a multifunctional antioxidant. Biofactors. 2003;17(1-4):207-13.

Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:339.

Bruzzese E, Raia V, Gaudiello G, et al. Intestinal inflammation is a frequent feature of cystic fibrosis and is reduced by probiotic administration. Aliment Pharmacol Ther. 2004;20(7):813-9.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea--a review. J Am Coll Nutr. 2006;25(2):79-99.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.

Cohen L, Kitzes R. Early radiation-induced proctosigmoiditis responds to magnesium therapy. Magnesium. 1985;4(1):16-19.

Collins SM, Barbara G, Vallance B. Stress, inflammation and the irritable bowel syndrome. Can J Gastroenterol. 1999;13(suppl. A):47A-49A.

Cvetnic Z, Vladimir-Knezevic S. Antimicrobial activity of grapefruit seed and pulp ethanolic extract. Acta Pharm. 2004;54(3):243-50.

Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther. 2006;4(2):261-75.

Gonclaves C, Dinis T, Batista MT. Antioxidant properties of proanthocyanidins of Uncaria tomentosa bark decoction: a mechanism for anti-inflammatory activity. Phytochemistry. 2005;66(1):89-98.

Gupta I, Parihar A, Malhotra P, et al. Effects of Boswellia serrata gum resin in patients with ulcerative colitis. Eur J Med Res. 1997;2(1):37-43.

LaValle JB, Krinsky DL, Hawkins EB, et al. Natural Therapeutics Pocket Guide. Hudson, OH:LexiComp; 2000: 452-454.

Maunder R, Esplen MJ. Facilitating adjustment to inflammatory bowel disease: a model of psychosocial intervention in non-psychiatric patients. Psychother Psychosom. 1999;68(5):230-240.

Melko GP, Turco TF, Phelan TF, Sauers NM. Treatment of radiation-induced proctitis with sucralfate enemas. Ann Pharmacother. 1999;33(12):1274-1276.

Miller AL. Therapeutic considerations of L-glutamine: A review of the literature. Alternative Medicine Review. 1999;4(4):239-248.

Nagata Y, Lee C, Anderson P, et al. Reduction of radiation damage in small intestine of rats by glutamine. Presented at: the 43rd Annual Meeting of the Radiation Research Society and the 15th Annual Meeting of the North American Hyperthermia Society. San Jose, Calif: 1995:178.

Owen RW, Giacosa A, Hull WE, Haubner R, Spiegelhalder B, Bartsch H. The antioxidant/anticancer potential of phenolic compounds isolated from olive oil. Eur J Cancer. 2000a;36(10):1235-1247.

Pan CX, Morrison RS, Ness J, Fugh-Berman A, Leipzig RM. Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of life: a systematic review. J Pain Symptom Manage. 2000;20(5):374-387.

Pinto A, Fidalgo P, Cravo M, et al. Short chain fatty acids are effective in short-term treatment of chronic radiation proctitis: randomized, double-blind, controlled trial. Dis Colon Rectum. 1999;42(6):788-796.

Reif S, Klein I, Lubin F, Farbstein M, Hallak A, Gilat T. Pre-illness dietary factors in inflammatory bowel disease. Gut. 1997;40(6):754-760.

Russel MG, Engels LG, Muris JW, et al. Modern life in the epidemiology of inflammatory bowel disease: a case-control study with special emphasis on nutritional factors [see comments]. Eur J Gastroenterol Hepatol. 1998;10(3):243-249.

Rompalo AM. Diagnosis and treatment of sexually acquired proctitis and proctocolitis: an update. Clin Infect Dis. 1999;28(suppl 1):S84-S90.

Schafer DW. Hypnosis and the treatment of ulcerative colitis and Crohn's disease. Am J Clin Hypn. 1997;40(2):111-117.

Scheppach W, Christl SU, Bartram HP, Richter F, Kasper H. Effects of short-chain fatty acids on the inflamed colonic mucosa. Scand J Gastroenterol Suppl. 1997;222:53-57.

Silk DB. Medical management of severe inflammatory disease of the rectum: nutritional aspects. Baillieres Clin Gastroenterol. 1992;6(1):27-41.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.

Tocchi A, Lepre L, Liotti G, et al. Familial and psychological risk factors of ulcerative colitis. Ital J Gastroenterol Hepatol. 1997;29(5):395-398.

Tytgat GN, Fockens P, Schotborgh RH, Hofer SO. Proctitis. Neth J Med. 1990;37(suppl 1):S37-S42.

Wang HK. The therapeutic potential of flavonoids. Expert Opin Investig Drugs. 2000;9(9):2103-19.

Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J. 2005;46(5):585-96.

Zhang ZH. Effect of acupuncture on 44 cases of radiation rectitis following radiation therapy for carcinoma of the cervix uteri. J Tradit Chin Med. 1987;7(2):139-140.

Zimmermann FB, Feldmann HJ. Radiation proctitis: Clinical and pathological manifestations, therapy and prophylaxis of acute and late injurious effects of radiation on the rectal mucosa. Strahlenther Onkol. 1998;174(suppl 3):85-89.

Review Date:
10/20/2006
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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