FitSugar

Acidophilus Pearls: The Goodness of Yogurt Without the Spoon

FitSugar — Mon, 28 Jul 2008 09:00:00 -0700

I'm sure you've all heard about how the live active cultures in yogurt are excellent for your digestive tract. If you have a hard time fitting in a cup of yogurt into your diets everyday or if you just don't eat dairy products, then Acidophilus Pearls, a type of probiotic supplement, were made for you then. It offers the benefits of acidophilus without the calories, cholesterol, sugars, or lactose found in yogurt. If you have tummy troubles, taking one capsule a day can help alleviate occasional gas and constipation plus symptoms of lactose intolerance. Plus these Pearls don't need to be refrigerated like other probiotic pills - and they even made the list of the best probiotics for your money.

Want to know what else probiotics are good for? Then read more

When it comes to your belly, probiotics assist the body's naturally occurring gut flora (useful microorganisms that live in the digestive tract) that often get out of whack because of the foods we eat, and they help maintain a balance of healthy bacteria. Not only that but they also support your immune system and benefit your skin. Taking probiotics can also reduce inflammation, lower cholesterol, lower blood pressure, improve mineral absorption, prevent yeast infections, and improve symptoms of Irritable Bowel Syndrome, and Colitis. Wow. All I know is that when I take them, I feel so much better.

Who knew they did all that. Do any of you take Acidophilus Pearls or another kind of probiotic?

Probiotics and Prebiotics: Bugs You Should Love

FitSugar — Wed, 28 Mar 2007 08:45:00 -0700

Are you a fan of probiotics? Maybe prebiotics? What's the difference anyway?

Probiotics - dietary supplements/foods containing good bacteria - are a big trend in supplements today. This is because they can help regulate your digestive system by managing lactose intolerance, preventing colon cancer, lowering cholesterol, lowering blood pressure, improving immune function and preventing infections, reducing inflammation, improves mineral absorption, prevents harmful bacterial growth under stress and improving systems of Irritable Bowel Syndrome and Colitis. That is quite a list!!!

The reason is because probiotics assist the body's naturally occurring gut flora (useful microorganisms that live in the digestive tract) that often get out of whack from the foods we eat to the antibacterial soap we use. That's one good bug. Probiotics can be found in yogurt (live & active cultures) and yeast, but they are most commonly consumed in supplement form. You can buy probiotic supplements from The Vitamin Shoppe.

While probiotics are getting increasing popular in the United States, evidence supports that the benefits of prebiotics - Non-digestible food ingredients that selectively stimulate the growth and/or activity of one or a limited number of bacteria in the colon, and improve host health- are a better way to increase good bacterial growth in the gut. Prebiotic foods include soybeans, Jerusalem artichokes, raw oats, unrefined wheat and unrefined barley. Prebiotics naturally occur in breast milk and are believed to play an important role in the development of a healthy immune system in infants.

Lactobacillus acidophilus

FitSugar — Wed, 08 Oct 2008 17:35:25 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Overview

Lactobacillus acidophilus (L. acidophilus) is the most commonly used probiotic, or "friendly," bacteria. Such healthy bacteria inhabit the intestines and vagina and protect against the entrance and growth of "bad" organisms that can cause disease. This is accomplished through a variety of mechanisms. For example, the breakdown of food by L. acidophilus leads to production of lactic acid, hydrogen peroxide, and other byproducts that make the environment hostile for undesired organisms. L. acidophilus also produces lactase, the enzyme that breaks down milk sugar (lactose) into simple sugars. People who are lactose intolerant do not produce this enzyme. Symptoms such as gas, bloating, and discomfort develop. For this reason, L. acidophilus supplements may be beneficial for these individuals.

Other potential probiotics include a variety of Lactobacillus species (spp.), such as the caseiGG, rhamnosus, NCFM, DDS-1, and johnsonii strains, Bifidobacterium longum, Bifidobacterium bifidum, Streptococcus thermophilus, Enterococcus faecium, Saccharaomyces boulardii, Bacillus spp., and Escherichia coli.

Prebiotics refers to the soluble fiber component found in certain foods or supplements that stimulate the growth of probiotics in the gastrointestinal tract. Examples include fructooligosaccharides (FOS).

Uses

Probiotics offer a variety of potential therapeutic uses. These include the following:

Vaginal infections

Several clinical studies support the use of Lactobacillus acidophilus vaginal suppositories in the treatment of bacterial vaginosis and candida (yeast) infections. A small number of clinical studies suggest that eating yogurt enriched with Lactobacillus acidophilus may be beneficial. Additional clinical research is needed.

Diarrhea prevention

Some clinical research exists that suggests Lactobacillus acidophilus may be effective when used to prevent diarrhea in travelers or in people taking antibiotics, although there are also some negative studies. Several probiotics (Saccharomyces boulardii and a mixture of Lactobacillus acidophilus and Bifidobacterium bifidum) had significant efficacy on treating traveler's diarrhea. No serious adverse reactions were reported in 12 clinical trials for this condition. Additional human studies are needed in these areas.

Other uses

Other uses of Lactobacillus acidophilus includes:

Replacing the "friendly" intestinal bacteria destroyed by antibiotics.
Aiding digestion and suppressing disease-causing bacteria.
Used in the treatment of chronic constipation.
Treating overgrowth of "bad" organisms in the gastrointestinal tract (a condition that tends to cause diarrhea and may occur from use of antibiotics).
Alleviating symptoms of irritable bowel syndrome and, possibly, inflammatory bowel disease (such as Crohn's disease and ulcerative colitis).
Preventing or reducing the recurrence of urinary tract infections, and cystitis (bladder inflammation).
Improving lactose absorption digestion in people who are lactose intolerant.
Enhancing the immune response. Studies have suggested that consumption of yogurt or milk that contains specific strains of Lactobacillus or supplements with Lactobacillus or Bifidobacterium may improve the natural immune response. Further research is needed to confirm these early findings and to best understand how the improved immune function may or may not help in warding off infections.
Aiding the treatment of respiratory infections such as sinusitis, bronchitis, and pneumonia. More research is needed in this area.
Lowering risk of allergies. Examples include asthma, hay fever, food allergies to milk, and skin reactions such as eczema.
Helping to treat high cholesterol.
Reducing the risk of recurring bladder tumors once this cancer has been treated.
Other conditions under investigation for use of probiotics include colon cancer, human immunodeficiency virus (HIV) related diarrhea, and Helicobacter pylori (an organism that can lead to development of ulcers).

Dietary Sources

The primary dietary sources of L. acidophilus include milk enriched with acidophilus, yogurt containing live L. acidophilus cultures, miso, and tempeh.

Prebiotics are found in breast milk, onions, tomatoes, bananas, honey, barley, garlic, and wheat.

Available Forms

L. acidophilus preparations consist of dried or liquid cultures of living bacteria. These cultures are usually grown in milk but can sometimes be grown in milk-free cultures. L. acidophilus is available in the following forms:

Freeze-dried granules
Freeze-dried powders
Freeze-dried capsules
Liquid L. acidophilus preparations
Yogurt enhanced with probiotics

L. acidophilus supplements should be refrigerated for best quality. However some preparations are in a spore form which is resistant to breakdown under normal temperatures and are often used by travelers who do not have access to refrigeration who use probiotics supplements to help prevent intestinal infections. Check the package label for storage instructions.

Prebiotics occur naturally in foods, but supplements provide a more concentrated source of this substance. Prebiotics are oligosacchrides, chains of sugar units linked together. Inulin is a long-chain oligosacchride (from 2 - 60 sugars) and fructooligosaccharides (FOS) are short-chain oligosaccharides (from 2 - 7 sugars). It is not clear at this time which type of prebiotic is most effective, although fructoligosaccarhides (FOS) are the most commonly used.

How to Take It

Pediatric

Newborns and Infants (0 - 1 year): Liquid preparations may be used as a lotion and applied topically to diaper area for yeast infections and diaper rashes. If the child is on antibiotic therapy, ¼ tsp or ¼ capsule can be taken orally, 2 hours after each dose of antibiotics to replace beneficial bacteria. Use products specifically formulated for infants. Always check with your pediatrician before giving dietary supplements to an infant or child.

Add ¼ tsp or ¼ capsule to water for the treatment of oral infections.

Adult

Recommended doses of L. acidophilus vary depending on the health condition being treated. Check the specific dosage recommendations on the product label. The following list provides guidelines for the most common uses:

For prevention or treatment of diarrhea: Take 1 -2 billion viable cells per day, called colony-forming-units or CFUs. Some health care providers may recommend up to 10 - 15 billion cells per day).

For vaginal infections: Take 8 ounces of yogurt (with live active cultures containing one of the Lactobacillus or Bifidobacterium strains listed above) daily or an oral daily supplement containing at least 1 - 2 billion live organisms. Clinical experience also suggests that placing yogurt with live acidophilus cultures directly to the vaginal area, using a disposable spatula and wearing a sanitary pad, helps to relieve itching and inflammation. Similarly, lactobacillus capsules or tablets may be inserted directly into the vagina.

For cystitis: Use 1 - 2 capsules or tablets inserted into the vagina nightly for 2 weeks.

For maintaining normal intestinal flora: Take 1 - 15 billion viable cells daily. If using for prevention of antibiotic associated diarrhea, start taking the probiotic supplement after conclusion of the antibiotic treatment.

If diarrhea occurs with the dosage you are taking, decrease the dosage or stop taking the product and talk with your health care provider.

Precautions

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.

Mild gastrointestinal upset and diarrhea may occur in some individuals (not on antibiotic therapy) who take more than 1 - 2 billion L. acidophilus cells daily.

There has been one report of anaphylaxis (a serious allergic reaction accompanied by shortness of breath and loss of consciousness) in a person taking inulin, a type of prebiotic.

Possible Interactions

If you are currently being treated with any of the following medications, you should not use Lactobacillus or other probiotics without first talking to your health care provider.

Sulfasalazine -- A laboratory study suggests that L. acidophilus speeds up metabolism of sulfasalazine, a medication used to treat ulcerative colitis. The significance of this information is unknown.

Supporting Research

Alvarez-Olmos MI. Probiotic agents and infectious diseases: a modern perspective on a traditional therapy. Clin Infect Dis. 2001;32(11):1567-1576.

Cunningham-Rundles S, Ahrne S, Bengmark S, et al. Probiotics and immune response. Am J Gastroenterol. 2000;95(1 Suppl):S22-25.

de Roos NM, Katan MB. Effects of probiotic bacteria on diarrhea, lipid metabolism, and carcinogenesis: a review of papers published between 1988 and 1998. Am J Clin Nutr. 2000;71(2):405-411.

de Vrese M, Marteau PR. Probiotics and prebiotics: effects on diarrhea. J Nutr. 2007;137(3 Suppl 2):803S-11S.

Donnet-Hughes A, et al. Modulation of nonspecific mechanisms of defense by lactic acid bacteria: effective dose. J Dairy Sci. May 1999; 82(5):863-869.

Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. [Review]. JAMA. 1996;275(11):870-876.

Ewaschuk JB, Dieleman LA. Probiotics and prebiotics in chronic inflammatory bowel diseases. World J Gastroenterol. 2006;12(37):5941-50.

Favier C, Neut C, Mizon C, Cortot A, Colombel JF, Mizon J. Fecal ß-D-galactosidase production and Bifidobacteria are decreased in Crohn's disease. Dig Dis Sci. 1997;42(4):817-822.

Fedorak RN, Madsen KL. Probiotics and the management of inflammatory bowel disease. Inflamm Bowel Dis. 2004;10(3):286-299.

Friedrich MJ. A bit of culture for children: probiotics may improve health and fight disease. JAMA. 2000;284(11):1365-1366.

Gill HS, Rutherford KJ, Cross ML. Dietary probiotic supplementation enhances natural killer cell activity in the elderly: an investigation of age-related immunological changes. J Clin Immunol. 2001;21(4):264-271.

Gill HS, Rutherford KJ, Cross ML, Gopal PK. Enhancement of immunity in the elderly by dietary supplementation with the probiotic Bifidobacterium lactis HN019. Am J Clin Nutr. 2001;74(6):833-839.

Gionchetti P, Rizzello F, Venturi A, Campieri M. Probiotics in infective diarrhea and inflammatory bowel diseases [Review]. J Gastroenterol Hepatol. 2000;15:489-493.

Gismondo MR, Drago L, Lombardi A. Review of probiotics available to modify gastrointestinal flora. Int J Antimicrob Agents. 1999;4:287-292.

Gorbach SL. Probiotics in the third millennium. Dig Liver Dis. 2002;34 Suppl 2:S2-S7.

Hatakka K, Savilahti, Ponka A, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centers: double-blind, randomized trial. BMJ. 2001;322(7298):1327.

Hilton E, Isenberg HD, Alperstein P, France K, Borenstein MT. Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginitis. Ann Intern Med. 1992;116(5): 353-357.

Hilton E, Kolakowski P, Singer C, Smith M. Efficacy of Lactobacillus GG as a diarrheal preventive in travelers. J Travel Med. 1997;4(1):41-43.

Hove H, Norgaard H, Mortensen PB. Lactic acid bacteria and the human gastrointestinal tract [Review]. Eur J Clin Nutr. 1999;53(5):339-350.

Ishida Y, Nakamura F, Kanzato H, et al. Effect of milk fermented with Lactobacillus acidophilus strain L-92 on symptoms of Japanese cedar pollen allergy: a randomized placebo-controlled trial.Biosci Biotechnol Biochem. 2005;69(9):1652-60.

Jang T, Saviano DA. In vitro fermentation by human colonic bacteria is modified by Lactobacillus acidophilus supplementation. J Nutr. 1997;127(:1489-1495.

Kalliomaki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomized placebo controlled trial. Lancet. 2001;357(9262):1076-1079.

Kontiokari T, Sundqvist K, Nuutinen M, Pokka T, Koskela M, Uhari M. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ. 2001;322:1571-1573.

McFarland LV. Meta-analysis of probiotics for the prevention of traveler's diarrhea. Travel Med Infect Dis. 2007;5(2):97-105.

Malin M, Suomalainen H, Saxelin M, Isolauri E. Promotion of IgA immune response in patients with Crohn's disease by oral bacteriotherapy with Lactobacillus GG. Ann Nutr Metab. 1996;40:137-145.

Marteau PR, de Vrese M, Cellier CJ, Schrezenmeir J. Protection from gastrointestinal diseases with the use of probiotics. Am J Clin Nutr. 2001;73(2 Suppl):430S-436S.

Meydani SN, Ha WK. Immunologic effects of yogurt. Am J Clin Nutr. 2000;71(4):861-872.

Michetti P, Dorta G, Wiesel PH, et al. Effect of whey-based culture supernatant of Lactobacillus acidophilus (johnsonii) La1 on Helicobacter pylori infection in humans. Digestion. 1999;60(3):203-209.

Pradhan A, Majumdar MK. Metabolism of some drugs by intestinal lactobacilli and their toxicological considerations. Acta Pharmacol Toxicol (Copenh). 1986;58(1):11-15.

Rani B, Khetarpaul N. Probiotic fermented food mixtures: possible applications in clinical anti-diarrhea usage. Nutr Health. 1998; 12(2): 97-105.

Reid G. Probiotic agents to protect the urogenital tract against infection. [Review]. Am J Clin Nutr. 2001;73(2 Suppl):437S-443S.

Rembacken BJ, Snelling AM, Hawkey PM, Chlamers DM, Axon ATR. Non-pathogenic Eschericia coli versus mesalazine for the treatment of ulcerative colitis: a randomized trial. Lancet. 1999;354:635-639.

Rolfe RD. The role of probiotic cultures in the control of gastrointestinal health. J Nutr. 2000;130(2S Suppl):396S-402S.

Sazawal S, Hiremath G, Dhingra U, Malik P, Deb S, Black RE. Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials. Lancet Infect Dis. 2006;6(6):374-82.

Scarpignato C, Rampal P. Prevention and treatment of traveler's diarrhea: a clinical pharmacological approach. [Review]. Chemotherapy. 1995;41 Suppl 1:48-81.

Schiffrin EJ, Brassart D, Servin AL, Rochat F, Donnet-Hughes A. Immune modulation of blood leukocytes in humans by lactic acid bacteria: criteria for strain selection. Am J Clin Nutr. 1997;66(2):515S-520S.

Shalev E, Battino S, Weiner E, Colodner R, Keness Y. Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis. Arch Fam Med. 1996;5(10):593-596.

Shanahan F. Probiotics and inflammatory bowel disease: is there a scientific rationale? Inflamm Bowel Dis. 2000;6(2):107-115.

Sheih YH. Systemic immunity-enhancing effects in health subjects following dietary consumption of the lactic acid bacterium Lactobacillus rhamnosus HN001. J Am Coll Nutr. 2001;20(2):149-156.

Szajewska H, Kotowska M, Mrukowicz JZ, Armanska M, Mikolajczyk W. Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J Pediatr. 2001;138(3):361-365.

Szajewska H, Mrukowicz JZ. Probiotics in the treatment and prevention of acute infectious diarrhea in infants and children: a systematic review of published randomized, double-blind, placebo-controlled trials. J Pediatr Gastroenterol Nutr. 2001;33 Suppl 2;S17-S25.

Tejada-Simon MV, Lee JH, Ustunol Z, Pestka JJ. Ingestion of yogurt containing Lactobacillus acidophilus and Bifidobacterium to potentiate immunoglobulin A responses to cholera toxin in mice. J Dairy Sci. 1999;82(4):649-660.

Van Niel CW, Feudtner C, Garrison M, Christakis DA. Lactobacillus thearpy for acute infections diarrhea in children: a meta-analysis. Pediatrics. 2002;109(4):678-684.

Vanderhoof JA, Whitney DB, Antonson DL, Hanner TL, Lupo JV, Young RJ. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Pediatr. 1999;135(5):564-568.

Review Date:
6/7/2007
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.

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).

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Probiotics: Beneficial or a Waste of Money?

FitSugar — Tue, 04 Nov 2008 09:00:00 -0800

Probiotics certainly were a health buzzword of 2008. These healthy bacteria can now be found in all sorts of products from dairy products to energy bars, from cereals to dietary supplements. These probiotic products claim to help with high blood pressure, digestive problems such as irritable bowel syndrome (IBS), and constipation. The question is, are they worth the money?

Many of the probiotic products on the market don't contain enough of the types of bacteria that studies have found offer health benefits, so they're not worth buying. Products worth your money should contain purified strains of specific microbes, such as B. Animalis (found in Dannon's Activia yogurt), or other specific strains of Bifidobacterium, or Lactobacillus. Check amounts as well. Studies show that doses between 100 million and 1 billion colony forming units (CFU) are effective for improving immune function, intestinal infections, and digestion. Acidophilus Pearls contain 1 billion CFU of Lactobacillus acidophilus and Bifidobacterium longum bacteria, so they're a great option. Since needs differ among people, some folks may benefit from one strain of microbes over another; if the Pearls aren't working for you, here's a list of some other probiotics to try.

Fit's Tip: While probiotics are in no way necessary for normal body function, if you're having digestive issues, you may benefit from taking them. Just so you know, in order to feel the effects you need to take them daily, and it may take a week or two to experience results.

If you have a probiotic product that you use, tell me about it in the comment section below.

Source

Many Probiotics Short on Bacteria

FitSugar — Fri, 20 Nov 2009 03:00:09 -0800

With claims that they improve digestion, bolster immunity, and fight acne, it's no wonder that probiotic supplements are big business. Newsweek reports that sales of these supplements have more than quadrupled in the last 10 years. I will admit, I'm a fan these friendly bacteria found in yogurt and miso, but it's the quality of the supplements that's raising eyebrows.

Many popular probiotic supplements were tested by Consumer Lab, an independent agency that monitors vitamins, herbal remedies, and supplements not regularly tested by the government. The lab's findings are a bit startling. Some of the products contain as little as 13 percent of the amount of "viable bacteria" claimed on the products' labels, although most products do contain one billion organisms - the amount needed to register some health benefits.

When it comes to misleading marketing with these supplements, much of the problem stems from the fact that the term probiotics has no legal definition and can be used loosely by manufactures. Of the supplements tested, ConsumerLab ranked Advocare Probiotic Restore, GNC Nature Brand Best Super Acidophilus, and Jarrow Formulas Jarro-Dophilus as having the highest quality. You can buy a full review from Consumer Lab for $12.

What's the Deal With: Probiotic Hummus

FitSugar — Tue, 04 Aug 2009 03:00:00 -0700

Predicted to be a food trend of 2009, Probiotics, those beneficial bacteria, are being added to all sorts of foods, from dairy products to energy bars. Probiotics have been found to support both the digestive and immune systems, prevent constipation, benefit your skin, and lower blood pressure. Yogurt is naturally chock full of the bacteria, but I just found a probiotic hummus made by Wildwood Organics.

To find out if its worth buying read more.

The list of ingredients reads: "garbanzo beans, garlic, probiotic cultures (L. acidophilus, Bifidobacterium ssp., L. casei) . . ." The label, however, doesn't list the amount of cultures. Many of these enhanced products don't contain enough bacteria to provide health benefits, so they're not worth paying the extra cash. Studies show that doses between 100 million and 1 billion colony-forming units (CFU) are effective for improving immune function, intestinal infections, and digestion. So if you want the benefits of probiotics, it's best to take them separately in supplement form, such as Acidophilus Pearls.

Infantile colic

FitSugar — Wed, 08 Oct 2008 17:35:25 -0700

Overview

Signs and Symptoms
What Causes It?
What to Expect at Your Provider's Office
Treatment Options
Following Up
Special Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Colicky babies cry constantly and hard at about the same time each day at least 3 days a week. About one in five babies develops colic. It is more common in boys and in firstborn children. It usually begins at about 2 weeks of age and goes away by the fourth month.

Signs and Symptoms

Your baby cries for more than 3 hours on at least three occasions a week, but is otherwise healthy.
Your baby kicks a lot, pulls their legs up close, and makes tight fists.
Your baby's tummy seems hard, and the baby burps and passes gas often.
The crying sounds like your baby is in great pain.
Your baby spits up frequently after feeding.

What Causes It?

Abdominal discomfort appears to be present, but one knows what actually causes colic. Possible causes include one or more of the following:

The baby's nervous or digestive system may be immature.
The baby needs comforting, or is over- or under-stimulated.
The baby swallows air, especially when feeding
The baby may be reacting to something in the mother's diet (if the baby is breastfed).
The baby has allergies to some foods, such as milk (if the baby is on formula).

What to Expect at Your Provider's Office

Your health care provider will ask if the baby is eating well and gaining weight or has diarrhea, fever, or unusual stools. If you are breastfeeding, your health care provider may ask about foods you have eaten. If your health care provider decides your baby has colic, you can work together to find ways to relieve your baby's discomfort.

Your health care provider will also encourage you to take care of yourself, like taking a break or getting help if you are afraid you will harm your baby. Remember that colic usually disappears between 4 - 6 months of age. If the treatments you choose do not work, your baby's health care provider may check for other problems, such as a digestive problem or allergy.

Treatment Options

If breastfeeding, nurse on demand, usually every 2 - 3 hours. Avoid caffeine, dairy products, citrus fruits, soy products, and spicy foods. Elevate the infant's head during and after feedings.
If bottle-feeding, ask your health care provider to recommend a formula that is not based on cow's milk and that is not iron-fortified. Keep the baby in a sitting position when feeding, and massage their back to get rid of gas bubbles. Burp after every ounce of formula.
Do not offer your baby solid foods before age 6 months.
Try the "colic carry" -- Place the baby, chest down, on your extended forearm, with their head supported by your hand and legs on either side of your elbow. Use your other hand to provide additional support and walk around with the baby.
Hold your baby close, offer a pacifier, try rocking or rubbing the back, give your baby a warm bath, take a car ride with the baby, play soft music, or use an infant swing to ease the crying.

Drug Therapies

No drugs are recommended, although simethicone, an over-the-counter gas remedy, may be helpful.

Complementary and Alternative Therapies

Eliminating gas-producing foods and using supportive herbal or homeopathic therapies may help reduce or eliminate infantile colic. Colic may be caused by a hidden food allergy. As a result, you may need to switch formula or food. A qualified natural health care provider can help you find nutritious hypo-allergenic foods for your child. If you are breastfeeding, eliminating gas-producing and potentially allergic foods from your diet may help. In addition, playing soft music, rocking the infant, or using "white noise" (for example, a dryer or even a vacuum cleaner) may be helpful in soothing the infant. Reducing stimuli and placing the infant in a dim, quiet room may help calm the baby.

Nutrition and Supplements

Acidophilus (especially Bifidusspp. ) can be given to both a breastfeeding mother and infant who takes a bottle, whether of breast milk or formula. Use 1 capsule (containing 5 - 10 billion CFUs per capsule) with meals three times per day for adults. Use one capsule per day for infants (break capsule open and add to bottle in divided doses throughout the day). Use acidophilus formulas specifically formulated for infants, such as Baby Jarrow-Dophilus. Some acidophilus products may need refrigeration. It is important to read the label carefully.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems, although many herbs that may be safe for adults may NOT be suitable for infants. As with any therapy, you should work with the baby's health care provider to get the problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas) or glycerites (glycerine extracts). Because of the alcohol content, do not give tinctures (alcohol extracts) to infants unless directed by your health care provider. Unless otherwise indicated, make teas with 1 tsp. hof erb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink two to four cups per day.

Inform your child's pediatrician about any herbs you may be using for your child and work with a qualified health care provider to develop the safest and most effective home remedy kit for your family.

You may give a tea made from fennel seed (Foeniculum vulgare) directly to the infant (1 tsp. before and after feedings) after it cools, or a breastfeeding mohter can drink it (1 cup three to six times per day). Fennel acts as a gastrointestinal relaxant and helps expel gas.

Teas and liquids made with the following herbs may also help:

Chamomile (Matricaria recutita ), vervain (Verbena officinalis ), fennel (Foeniculum vulgare ), and lemon balm (Melissa officinalis). Give about 1/2 cup of tea up to three times per day.
Caraway (Carum carvi) helps reduce intestinal cramping. Combine 1 teaspoon of caraway seed with 8 ounces boiled water and steep for 10 minutes. Add 3 ounces of vegetable glycerin. Strain and give a 1/2 teaspoon 15 minutes before feeding.
Other herbs that may help reduce calm the baby or reduce gas include linden (Tilia cordata), catnip (Nepeta cataria), peppermint (Mentha piperita), and dill (Anethum graveolens ). They can be combined with the teas above.
Slippery elm bark (Ulmus fulva) helps soothe the digestive system and can be used as a tea. You can also combine the powdered bark with water and make a meal of slippery elm “gruel," similar in consistency to instant oatmeal. Check with your child's pediatrician first before using slippery elm gruel in your child’s diet.

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. However, a professional homeopath may recommend one or more of the following treatments for infantile colic based on their knowledge and clinical experience.

Viburcol, a proprietary homeopathic medicine often used in Europe, can be very effective for acute colic. It contains Chamomilla, Belladonna, Dulcamara, Plantago major, Pulsatilla, and Calcium carbonicum Hahnemanni.

Aethusa -- for infants who cannot digest milk, who vomit, and have diarrhea.
Belladonna -- for colic with spasms that come and go quickly. The abdomen may feel warm to the touch and symptoms may coincide with constipation. Bending forward may relieve pain.
Bryonia -- for pain worsened by movement and pressure. This remedy is most appropriate for irritable infants who lie still with knees drawn up.
Carbo vegetabilis-- for colic with a distended abdomen and burping or belching. The face may be pale, and hands and feet feel cold.
Chamomilla -- for excessively irritable and screaming infants who are relieved by constant holding and rocking. Infants for whom this remedy is appropriate are often teething and have green, foul-smelling diarrhea.
Colocynthis -- for restless, irritable infants whose symptoms of colic are relieved by firm pressure. In these infants, diarrhea and pain may occur after eating fruit. Infant tends to bring knees up to their abdomen.
Lycopodium -- for infants who can not stand pressure on the abdomen (even diapers must be worn loosely). Symptoms tend to worsen between 4 and 8 p.m., and then again after midnight.
Magnesia phos -- for infants whose symptoms of colic are relieved with gentle pressure or warmth applied to the abdomen, or while they are bent over. Belching does not relieve pain.
Natrum phos --for colic with no other distinguishing symptoms.
Nux vomica --for colic that occurs when a breastfeeding mother eats rich food, drinks alcohol, or coffee. The infant may arch its back and appear angry.
Pulsatilla --for infants with bloated abdomens after eating, and constipation alternating with diarrhea. May be aggravated by warm rooms, heat, or if the diet of the breastfeeding mother includes fruits, fats, pastries, or ice cream. Relieved by rocking.

Chiropractic

Chiropractors frequently treat infantile colic with a form of gentle spinal manipulation specially modified for infants. The duration of treatment is generally brief, consisting of three to four visits over a period of 2 weeks. Studies examining the effectiveness of chiropractic for infantile colic have produced mixed results, however.

Physical Medicine

Warm baths may help relax and soothe colicky infants. Add three to four drops of essential oil of lavender or lemon balm to enhance the benefit.

Gently pinching or squeezing the acupressure point between the baby's thumb and finger (on the webbing) may help to calm a fussy child.

Massage

Clockwise abdominal massage may help relieve spasm and expel gas. Use three to five drops of tincture of catnip in 1 - 2 tsp. of almond or olive oil to enhance effectiveness. Apply warmth.

Following Up

Use whatever works, and remember that your baby will outgrow the colic in a few weeks or months. Keep in mind, however, that colicky babies often grow up to have other allergy-related health problems, such as ear infections, asthma, and digestive problems.

Special Considerations

Never shake your baby. This can cause serious or fatal brain damage. If you are feeling overwhelmed, try the following steps:

Have someone else watch your baby while you get away for a while.
Join a support group.
Call your baby's health care provider.

Supporting Research

Alexandrovich I, Rakovitskaya O, Kolmo E, et al. The effect of fennel (Foeniculum vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study. Altern Ther Health Med. 2003;9:58-61.

Boericke W. Materia Medica. 9th ed. Santa Rosa, Calif: Boericke and Tafel; 1927:151.

Crotteau CA, Wright ST, Eglash A. Clinical inquiries. What is the best treatment for infants with colic? J Fam Pract. 2006;55(7):634-6.

Gupta SK. Update on infantile colic and management options. Curr Opin Investig Drugs. 2007;8(11):921-6.

Herman M, Le A. The crying infant. Emerg Med Clin North Am. 2007;25(4):1137-59, vii.

Howard CR, Lanphear N, Lanphear BP, Eberly S, Lawrence RA. Parental responses to infant crying and colic: the effect on breastfeeding duration. Breastfeed Med. 2006;1(3):146-55.

Pina DI, Llach XB, Arino-Armengol B, Iglesias VV. Prevalence and dietetic management of mild gastrointestinal disorders in milk-fed infants. World J Gastroenterol. 2008;14(2):248-54.

Rosen LD, Bukutu C, Le C, Shamseer L, Vohra S. Complementary, holistic, and integrative medicine: colic. Pediatr Rev. 2007;28(10):381-5.

Savino F, Cresi F, Castagno E, et al. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officialis (ColiMil) in the treatment of breast-fed colicky infants. Phytother Res. 2005;19:335-40.

Savino F. Focus on infantile colic. Acta Paediatr. 2007;96(9):1259-64.

Wade S. Infantile colic. Clin Evid. 2006;(15):439-47.

Zwart P, Vellema-Goud MG, Brand PL. Characteristics of infants admitted to hospital for persistent colic, and comparison with healthy infants. Acta Paediatr. 2007;96(3):401-5.

Review Date:
2/12/2008
Reviewed By:
Steven D. Ehrlich, NMD, private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources,

A.D.A.M. Copyright

adam.com

Gout

FitSugar — Wed, 08 Oct 2008 17:35:15 -0700

Overview

Signs and Symptoms
What Causes It?
What to Expect at Your Provider's Office
Treatment Options
Following Up
Special Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Gout is a type of arthritis that occurs when too much uric acid builds up in the body, causing crystals to form in joints, and joints to become inflamed. It can be hereditary or the result of another condition. Gout usually affects men over 40 with a family history of gout, but it can occur at any time and also affects women, especially after menopause. Excessive intake of food and alcohol, surgery, infection, physical or emotional stress, or the use of certain drugs can lead to the development of gout symptoms.

Signs and Symptoms

Extreme pain in a single joint, usually the base of the big toe; it can also affect other joints (such as the feet, fingers, wrists, elbows, knees, or ankles).
Joint is shiny red-purple, swollen, hot, and stiff.
Fever as high as 39°C (102.2°F) with or without chills.
Symptoms can develop very quickly, with the first episode often occurring at night, then go away after 5 - 10 days only to come back later.
In later attacks, you may see lumps (called tophi) just under the skin in the outer ear, hands, feet, elbow, or knee.

What Causes It?

The body produces too much uric acid, doesn't excrete enough uric acid, or both, so that the acid accumulates in tissues in the form of needle-like crystals that cause pain. Gout generally occurs because of a predisposition to the condition, but it can result from blood disorders or cancers, such as leukemia, or the use of certain drugs. Risk factors include:

Family history of gout
High levels of triglycerides
Drinking too much alcohol
Eating foods rich in purines, such as meat, shellfish, and sweetbreads. Uric acid is formed when purines break down.

What to Expect at Your Provider's Office

Your health care provider will examine the affected joint, evaluate your pain, and may ask if there is any history of gout in your family. Your health care provider may take a sample of fluid from the affected joint, draw blood for a blood test, or take x-rays to rule out other possibilities.

Treatment Options

Your health care provider may give you ibuprofen or another nonsteroidal anti-inflammatory drug (NSAID) to help with the pain and swelling. You must avoid alcohol and foods that trigger your attacks. Besides NSAIDs, you may recieve other drugs. Colchicine can help treat an acute attack and prevent future attacks but has serious side effects. Probenecid (Benemid), allopurinol (Zyloprim), and sulfinpyrazone (Anturane) also help prevent future attacks. These drugs help control gout but do not cure it.

Complementary and Alternative Therapies

A combination of therapies can be very effective at decreasing both the length and frequency of attacks.

Nutrition and Supplements

These nutritional tips may help reduce symptoms:

Eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your healthcare provider may test for food sensitivities.
Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers). One half pound of cherries per day (fresh or frozen) for 2 weeks lowers uric acid and prevents attacks. Cherry juice (8 - 16 oz. per day) is also helpful.
Eat more high fiber foods, including beans, oats, root vegetables (such as potatoes and yams), and psyllium seed.
Avoid refined foods, such as white breads, pastas, and sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
Cut down on oxalate-containing foods, such as spinach, rhubarb, beets, nuts, chocolate, black tea, wheat bran, strawberries, and beans.
Include foods rich in magnesium and low in calcium, such as barley, bran, corn, rye, oats, soy, brown rice, avocado, banana, and potato.
Restrict purines in your diet. Foods with a high purine content include beef, goose, organ meats, sweetbreads, mussels, anchovies, herring, mackerel, and yeast. Foods with a moderate amount of purines include meats, poultry, fish, and shellfish not listed above. Spinach, asparagus, beans, lentils, mushrooms, and dried peas also contain moderate amounts of purines.
Use healthy cooking oils, 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 six to eight glasses of filtered water daily to help flush uric acid from the body. Dehydration often triggers a gout attack.
Exercise at least 30 minutes daily, 5 days a week.

You may address nutritional deficiencies with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc and selenium.
Omega-3 fatty acids, such as fish oil, 1- 2 capsules or 1 tablespoons of oil daily, to help decrease inflammation and help in general health. Cold-water fish, such as salmon or halibut, are good sources. Talk to your health care provider before taking omega-3 supplements if you are taking blood thinning medications, such as aspirin or warfarin (Coumadin).
IP-6 (inositol hexophosphonate), 1 - 8 grams daily on an empty stomach, for kidney health. Check with your alternative healthc are provider for proper dosing.
N-acetyl cysteine, 200 mg daily, for antioxidant effects.
Vitamin C, 500 - 1,000 mg daily, as an antioxidant.
Acidophilus (Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units), when needed for maintenance of gastrointestinal and immune health. Some acidophilus products may need refrigeration. Check the labels carefully.
Methylsulfonylmethane (MSM), 3,000 mg twice a day, to help decrease inflammation.
Avoid taking extra niacin and vitamin A. Both may play a role in some attacks of gout.

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 two to four cups per day. You may use tinctures alone or in combination as noted.

Cranberry (Vaccinium macrocarpon) standardized extract, 300 - 400 mg daily, for kidney health. You may also take 8-16 ounces of unsweetened cranberry juice daily.
Green tea (Camelia 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.
Devil's claw (Harpagophytum procumbens), standardized extract, 750 mg three times daily, for pain and inflammation.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for inflammation, immune, and antibacterial/antifungal activity.
Bromelain (Ananus comosus) standardized extract, 40 mg three times daily, for pain and inflammation.
Turmeric (Curcuma longa ) standardized extract, 300 mg three times a day, for inflammation.

Homeopathy

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of gastritis symptoms (such as nausea and vomiting) based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for you individually.

Some of the most common remedies used for gout are listed below. A common dose is three to five pellets of a 12X to 30C remedy every 1 - 4 hours until your symptoms improve.

Aconite for sudden onset of burning pain, anxiety, restlessness, and attacks that come after a shock or injury. Also take if your joints are swollen and painful.
Belladonna for intense pain that may be throbbing, if pain is made worse by any motion and better by pressure, or if the joint is very hot.
Berberis vulgaris for spasms of pain in joints or twinges made worse by walking. There may be back pain and a tendency to develop kidney stones.
Bryonia for pain made much worse by any kind of motion, or if pain is better with pressure and with heat.
Colchicum for pains made worse by motion and changes of weather, especially if there is any nausea associated with the attacks.
Ledum when joints become mottled, purple, and swollen, or if the pain is much better with cold applications and is worse when overheated.
Rhus toxicodendron for stiff, swollen joints that are hot and painful, or if the pain is worse with cold applications and better with heat.

Physical Medicine

Hot and cold compresses -- Alternating hot compress for 3 minutes with a cold one for 30 seconds provides pain relief and increases circulation.
Nettle tea compress, applied externally. Use 1 - 2 tsp. per cup of hot water.

Following Up

If you have had several attacks and the joint is damaged, your health care provider may refer you to an orthopedic specialist.

Special Considerations

People who have had gout have an increased risk of developing kidney stones, high blood pressure, kidney disease, diabetes, high levels of triglycerides, and atherosclerosis.

Supporting Research

Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008; [Epub ahead of print].

Choi HK. Diet, alcohol, and gout: how do we advise patients given recent developments? Curr RheumatolRep. 2005;7(3):220-6.

Eggebeen AT. Gout: an update. Am Fam Physician. 2007;76(6):801-8. Review.

Falasca GF. Metabolic diseases: gout. Clin Dermatol. 2006;24(6):498-508.

Gagnier JJ, Chrubasik S, Manheimer E. Harpgophytum procumbens for osteoarthritis and low back pain: a systematic review. BMC Complement Altern Med. 2004 Sep 15;4:13.

Lee SJ, Terkeltaub RA, Kavanaugh A. Recent developments in diet and gout. Curr Opin Rheumatol. 2006;18(2):193-8.

Li EK. Gout: a review of its aetiology and treatment. Hong Kong Med J. 2004;10(4):261-70.

Pascual E, Sivera F. Therapeutic advances in gout. Curr Opin Rheumatol. 2007;19(2):122-7.

Saag KG, Choi H. Epidemiology, risk factors, and lifestyle modifications for gout. ArthritisRes Ther. 2006;8 Suppl 1:S2.

Schumacher HR Jr, Chen LX. Newer therapeutic approaches: gout. Rheum Dis Clin North Am. 2006;32(1):235-44, xii. Review.

Wegener T, Lupke NP. Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC.). Phytother Res 2003;17(10):1165-1172.

A.D.A.M. Copyright

adam.com

Menstrual pain

FitSugar — Wed, 08 Oct 2008 17:34:56 -0700

Overview

Signs and Symptoms
What Causes It?
What to Expect at Your Provider's Office
Treatment Options
Following Up
Special Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Menstrual pain is a common gynecological complaint in adolescents, but the majority of cases are not associated with a disease.

Primary dysmenorrhea is the medical term for menstrual pain.

Primary dysmenorrhea usually begins 2 - 3 years after the first period, once ovulation is established. Pain usually begins a day or two before menstrual flow, and may continue through the first 2 days of menstruation. Discomfort tends to decrease over time and after pregnancy.

Secondary dysmenorrhea is caused by underlying conditions, such as endometriosis and pelvic inflammatory disease.

Signs and Symptoms

Symptoms and degree of pain vary, but may include the following:

Abdominal cramping or dull ache that moves to lower back and legs
Heavy menstrual flow
Headache
Nausea
Constipation or diarrhea
Frequent urination
Vomiting (not common)

What Causes It?

Primary dysmenorrhea is caused by strong uterine contractions brought on by an increase in prostaglandin. Prostaglandin is a hormone that causes muscle spasms of the uterus (endometrium).

Secondary dysmenorrhea can be caused by:

Endometriosis (inflammation of the lining of the uterus)
Blood and tissue being discharged through a narrow cervix
Uterine fibroid or ovarian cyst
Infections of the uterus
Pelvic inflammatory disease (PID)
Intrauterine device (IUD)

What to Expect at Your Provider's Office

A pelvic examination may include an internal examination, laparoscopy, and ultrasound. You may need a Pap test or D&C to analyze tissue. Blood and urine samples may be required.

Treatment Options

Drug Therapies

Initial treatment is focused on relief of pain. Anti-inflammatory medications can be helpful. This includes over-the-counter (OTC) medications such as aspirin, nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Motrin, Advil), and prescription medications. (Note: Long-term use of NSAIDs can lead to gastrointestinal bleeding.)

Oral contraceptives may be prescribed in severe cases for disorders such as endometriosis.

If menstrual pain results from pelvic inflammatory disease (PID), antibiotics will be prescribed.

Complementary and Alternative Therapies

Dysmenorrhea may be effectively treated with nutritional support and mind-body techniques (such as meditation) and exercises (such as yoga and tai chi).

Nutrition and Supplements

Eliminate potential food allergens, including dairy, wheat (gluten), corn, soy, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
Eat calcium-rich foods, including beans, almonds, and dark green leafy vegetables (such as spinach and kale).
Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell pepper).
Avoid refined foods, such as white breads, pastas, and sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy), or beans for protein.
Use healthy cooking oils, such as olive oil or vegetable oil.
Drink soy milk for bone health and symptoms of menstrual pain.
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-complex vitamins and trace minerals such as magnesium, calcium, zinc and selenium.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tbsp. oil daily, to help decrease inflammation.
Acidophilus (Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and vaginal health. Some acidophilus products may require refrigeration. It is important to read the label carefully.
Calcium citrate, 500 - 1,000 mg daily, for bone support and symptoms of menstrual pain.
Vitamin D, 400 IU daily, for bone support and symptoms of menstrual pain.
Ipriflavone (soy isoflavones) standardized extract, 200 mg three times a day, for bone loss and symptoms of menstrual pain.
Progesterone cream, 1/8 - ¼ teaspoonful (depending upon extract strength) applied topically daily on days 7 - 28 of cycle, for symptoms of menstrual pain.
Omega-3 fatty acids, such as flaxseed and fish oils, 1 - 2 capsules or 1 tbsp. oil daily, to help decrease inflammation.
Melatonin, 2 - 5 mg before bed, for sleep regulation. Talk to a health care provider before using melatonin if you are taking antidepressant medications.

Herbs

Herbs are generally available as standardized dried extracts (pills, capsules, or tablets), teas, or tinctures/liquid extracts (alcohol extraction, unless otherwise noted). Mix liquid extracts with favorite beverage. Dose for teas is 1 - 2 heaping teaspoonfuls/cup water steeped for 10 - 15 minutes (roots need to be steeped longer).

The following herbal remedies may provide relief from symptoms:

Chaste tree (Vitex agnus castus) standardized extract, 20 - 40 mg daily before breakfast, for symptoms of menstrual pain.
Black cohosh (Actaea racemosa) standardized extract, 20 - 40 mg two times a day, for symptoms of pre-menstrual syndrome.
Evening primrose oil (Oenothera biennis) standardized extract, 500 - 1000 mg daily, as a source of gamma linolenic acid (GLA), for symptoms of menstrual pain.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for inflammation.
Bromelain (Ananus comosus) standardized extract, 40 mg three times daily, for pain and inflammation.
Turmeric (Curcuma longa) standardized extract, 300 mg three times a day, for inflammation.

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. However, a professional homeopath may recommend one or more of the following treatments for menstrual pain based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

Belladonna -- for acute menstrual pain that often resembles labor pains; for pain often described as sharp, throbbing pressure in the pelvis accompanied by heavy bleeding; and for pain that may extend to the back and tends to worsen with walking or moving.
Chamomilla -- for menstrual pain with mood changes, including irritability and anger, and pain occuring after bouts of anger. The individual may have the sensation of a weight on her pelvis.
Cimicifuga -- for pain that moves from one side of the abdomen to the other and that is worsened by movement.
Colocynthis -- for sharp pain accompanied by anger and irritability.
Lachesis -- for pain and pressure that extend to the back. Symptoms tend to worsen at night.
Magnesia phos -- for cramps or sharp, shooting pains that are relieved by warmth, pressure, and bending forward.
Nux vomica -- for cramping pains that extend to the lower back; these pains are often accompanied by nausea, chills, irritability, and a sensitivity to light, noise, and odors.
Pulsatilla -- for menstrual pains accompanied by irritability, moodiness (including feelings of sadness), dizziness, fainting, nausea, diarrhea, back pain, and headaches; there may be more pain when there is no menstrual flow.

Physical Medicine

The following methods can relieve pelvic pain:

Castor oil pack. Apply oil directly to skin, cover with a clean soft cloth (for example, flannel) and plastic wrap. Place a heat source (hot water bottle or heating pad) over the pack and let sit for 30 - 60 minutes. For best results use 3 consecutive days in 1 week.
Contrast sitz baths. Use two basins that you can comfortably sit in. Sit in hot water for 3 minutes, then in cold water for 1 minute. Repeat three times to complete one set. Do one to two sets per day, 3 - 4 days per week.

Acupuncture

The National Institutes of Health recommend acupuncture as either a supplemental or alternative treatment for dysmenorhea. This recommendation is supported by a well-designed trial involving 43 women with dysmenorrhea. Women treated with acupuncture showed a dramatic reduction in both pain and the need for pain medication

Acupuncture has become a popular treatment for dysmenorrhea. Acupuncturists treat people with dysmenorrhea based on an individualized assessment of the excesses and deficiencies of energy (called qi) located in various meridians. In the case of dysmenorrhea, a qi deficiency is usually detected in the liver and spleen meridians. Moxibustion (a technique in which the herb mugwort is burned over specific acupuncture points) is often added to enhance needling treatment, and qualified practitioners may also recommend herbal or dietary treatments.

Acupressure is also effective at reducing the pain. A study of 216 female students found that acupressure and ibuprofen were significantly better than a placebo, or “dummy pill,” at reducing pain.

Chiropractic

Some people with dysmenorrhea may benefit from spinal manipulation (particularly in areas that supply sensory and motor impulses to the uterus and lower back). Studies of women with a diagnosis or history of primary dysmenorrhea have found that spinal manipulation improves symptoms, but no more effectively than sham manipulation. Sham manipulation refers to maneuvers that shift soft tissues surrounding the bone but do not actually adjust the spine or joint. Sham manipulation has been compared to placebo because both procedures look and feel the same. Interestingly, however, experts are now questioning whether sham is a fair placebo because the massage quality of the manipulation may also have a beneficial effect.

Following Up

If your symptoms change, or treatment does not help, tell your provider.

Special Considerations

Avoid caffeine, alcohol, and sugar prior to onset of your period.

Supporting Research

Balbi C, Musone R, Menditto A, et al., Influence of menstrual factors and dietary habits on menstrual pain in adolescence age. Eur J Obstet Gynecol Reprod Biol. 2000;91(2):143-8.

Barnard ND, Scialli AR, Hurlock D, Bertron P. Diet and sex-hormone binding globulin, dysmenorrhea, and premenstrual symptoms. Obstet Gynecol. 2000;95(2):245-50.

Dennehy CE. The use of herbs and dietary supplements in gynecology: an evidence-based review. J Midwifery Womens Health. 2006;51(6):402-9.

Fjerbaek A, Knudsen UB. Endometriosis, dysmenorrhea and diet -- what is the evidence? Eur J Obstet Gynecol Reprod Biol. 2007;132(2):140-7.

Grimes DA, Hubacher D, Lopez LM, Schulz KF. Non-steroidal anti-inflammatory drugs for heavy bleeding or pain associated with intrauterine-device use. Cochrane Database Syst Rev. 2006;(4):CD006034.

Habek D, Cortez Habek J, Bobic-Vukovic M, Vujic B. Efficacy of acupuncture for the treatment of primary dysmenorrheal. Gynakol Geburtshilfliche Rundsch. 2003 Oct;43(4):250-253.

Letzel H, Megard Y, Lamarca R, Raber A, Fortea J. The efficacy and safety of aceclofenac versus placebo and naproxen in women with primary dysmenorrhoea. Eur J Obstet Gynecol Reprod Biol. 2006;129(2):162-8.

Nagata C, Hirokawa K, Shimizu N, Shimizu H. Associations of menstrual pain with intakes of soy, fat and dietary fiber in Japanese women. Eur J Clin Nutr. 2005;59(1):88-92.

Pouresmail Z, Ibrahimzadeh R. Effects of acupressure and ibuprofen on the severity of dysmenorrheal. J Tradit Chin Med 2002 Sep;22(3):205-210.

Proctor ML, Murphy PA, Pattison HM, Suckling J, Farquhar CM. Behavioural interventions for primary and secondary dysmenorrhea. Cochrane Database Syst Rev. 2007;(3):CD002248.

Proctor ML, Hing W, Johnson TC, Murphy PA. Spinal manipulation for primary and secondary dysmenorrhea. Cochrane Database Syst Rev. 2006;3:CD002119.

Proctor ML, Latthe PM, Farquhar CM, Khan KS, Johnson NP. Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhea. Cochrane Database Syst Rev. 2005 Oct 19; (4):CD001896.

Tugay N, Akbayrak T, Demirturk F, et al. Effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea. Pain Med. 2007;8(4):295-300.

Review Date:
12/7/2007
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, NMD, private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

adam.com

Osteoarthritis

FitSugar — Wed, 08 Oct 2008 17:34:55 -0700

Overview

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

HEALTH GUIDE REFERENCE FROM A.D.A.M

Osteoarthritis (OA) is the most common form of arthritis. It is a joint disease caused by the breakdown of cartilage -- the firm, rubbery tissue that cushions bones at joints.

Healthy cartilage allows bones to glide over one another, and cartilage absorbs energy from the shock of physical movement. In OA cartilage breaks down and wears away. As a result, the bones rub together causing pain, swelling, and stiffness.

OA may also limit the range of motion in affected joints. Most often, OA develops in the hands, knees, hips, and spine.

The disease affects men and women nearly equally. More than 20 million people in the United States have OA. Symptoms tend to appear when individuals are in their 50s and 60s.

Signs and Symptoms

Signs and symptoms of OA may include the following:

Joint pain (often a deep, aching pain) that is worsened by movement and improved with rest (in severe cases, a person may experience constant pain)
Stiffness in the morning or after being inactive for more than 15 minutes
Joint swelling
Joints that are warm to the touch
Crunching or crackling noise when the joint moves (crepitation)
Limited range of motion
Muscle weakness
Abnormal growth of bony knobs near joints which cause deformities (such as Heberden's nodes, in which bumps appear on the outermost finger joints)

Causes

Most of the time, the cause of OA is unknown. It is primarily a disease due to aging. However, metabolic, genetic, chemical, and mechanical factors can play a role in its development.

Risk Factors

Risk factors for OA include:

Increasing age
Genetic predisposition
Obesity
Injury to the joint
History of inflammatory joint disease
Metabolic or hormonal disorders (such as hemochromatosis and acromegaly)
Bone and joint disorders present at birth
Repetitive stressful joint use (such as with occupations like baseball, ballet dancing, and construction work)
Deposits of uric acid crystals in joints

Diagnosis

There is no single test to diagnose OA, so most doctors use a combination of methods to diagnose the disease and rule out the possibility other causes. A physical exam can show limited range of motion, grating of a joint with motion, joint swelling, and tenderness. An x-ray of affected joints will show loss of the joint space and, in advanced cases, wearing down of the ends of the bone and bone spurs.

Preventive Care

The following measures may reduce the risk of developing OA:

Protecting an injured joint from further damage
Exercising
Losing weight
Avoiding excessive repetitive motions

Treatment

The goals of treatment are to relieve pain, maintain or improve joint mobility, increase the strength of the joints, and minimize the disabling affects of the disease. The specific treatment depends upon the affected joints. A combination of conventional treatment and complementary and alternative medicine (CAM) may be most effective. Lifestyle approaches, including exercise, and many alternative medical therapies are becoming more popular and are considered safe and effective for the treatment OA.

Several natural remedies are at least as effective as conventional medication for symptom relief, and may help keep the disease from getting worse. Americans spend more on natural remedies for OA than for any other medical condition. Some of the most promising complementary approaches for treating OA include:

Reducing physical stress on the joint (lose weight and improve posture)
Lifestyle changes (particularly exercise)
Supplements including S-adenosylmethionine (SAMe), glucosamine and chondroitin, and antioxidants
Herbs with anti-inflammatory properties, including boswellia, devil's claw, ginger, turmeric, white willow bark, and capsaicin (cream)
Acupuncture, including TENS or transcutaneous electrical nerve stimulation
Chiropractic
Physical therapy and magnet therapy
Yoga
Tai chi

Exercise

Exercise to strengthen, stretch, and relax muscles around affected joints is almost always included in a treatment plan for OA. Several clinical studies support the value of exercise for people with OA. Clinical studies also suggest that in addition to reduction of pain and disability, exercise improves strength, range of motion, balance and coordination, endurance, and posture.

Medications

The most common type of medication used to treat osteoarthritis are nonsteroidal, anti-inflammatory drugs (NSAIDs). They are common pain relievers that reduce pain and swelling. Types include aspirin, ibuprofen (Motrin, Advil, Nuprin), and naproxen (Aleve, Naprosyn, Anaprox). Although NSAIDs work well, long-term use can cause stomach problems, such as ulcers and bleeding. In April 2005, the U.S. Food and Drug Administration (FDA) asked drug manufacturers of NSAIDs to include a warning label on their product that alerts users of an increased risk for stomach bleeding.

Other medications used to treat OA include:

COX-2 inhibitors (coxibs) -- Coxibs block an inflammation-promoting enzyme called COX-2. This class of drugs was initially believed to work as well as traditional NSAIDs, but with fewer stomach problems. However, numerous reports of heart attacks and stroke have prompted the FDA to re-evaluate the risks and benefits of the COX-2s. Rofecoxib (Vioxx) and valdecoxib (Bextra) have been withdrawn from the U.S. market following reports of heart attacks in some patients taking the drugs. Celecoxib (Celebrex) is available and labeled with strong warnings and a recommendation that it be prescribed at the lowest possible dose for the shortest duration possible. Patients should ask their doctor whether the drug is appropriate and safe for them.
Corticosteroids -- Also known as steroids, these medications are injected directly into the joint. They may also be used to reduce inflammation and pain. Steroids for inflammation inlclude prednisone (Deltasone) and dexamethasone (Decadron). Steroids, however, may cause side effects, such as weight gain, nausea, and fluid accumulation (edema). Steroids may also cause drug interactions. Ask a pharmacist or doctor.
Artificial joint fluid (Synvisc, Hyalgan) -- These medications can be injected into the knee. They may temporary relief pain for up to 6 months.

Surgery and Other Procedures

Surgery to replace or repair damaged joints may be needed in severe, debilitating cases. Surgical options include:

Arthroplasty (total or partial replacement of the deteriorated joint with an artificial joint)
Arthroscopic surgery to trim torn and damaged cartilage and wash out the joint
Osteotomy (change in the alignment of a bone to relieve stress on the bone or joint)
Arthrodesis (surgical fusion of bones, usually in the spine)

Nutrition and Dietary Supplements

Following these nutritional tips may help reduce symptoms:

Eliminate potential food allergens and foods that increase mucous production, including dairy (milk, eggs, cheese, sour cream, and ice cream), wheat (gluten), soy, corn, potatoes, cabbage, bananas, sugar, preservatives, food additives and excessive salt and meats. Your health care provider may want to test for food sensitivities.
Eat more foods that decrease inflammation, including garlic, onions, watercress, horseradish, mustard, parsley, celery, rose hips tea, pickles, lemon, and anti-inflammatory oils (nuts, seeds, cold-water fish).
Eat more foods containing digestive enzymes, such as papaya and pineapple.
Avoid refined foods, such as white breads, pastas, and sugars.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
Use healthy cooking oils, 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 moderately, for 30 minutes daily, 5 days a week.

You can address nutritional deficiencies with the following supplements:

Glucosamine/chondroitin, 500 - 1,500 mg daily, for joint health.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tbsp. oil daily, to help decrease inflammation and improve immunity. Higher doses may be used by health care providers.
A multivitamin daily, containing the antioxidant vitamins A, C, D, E, the B-vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium.
Digestive enzymes, 1 - 2 tablets three times daily with meals.
Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant and immune activity.
N-acetyl cysteine, 200 mg daily, for antioxidant effects.
Acidophilus (Lactobacillus acidophilus), 5-10 billion CFUs (colony forming units) daily, when needed for maintenance of gastrointestinal and immune health. You should refrigerate your acidophilus products.
SAMe (s-adenosyl-L-methionine), 100 - 200 mg before breakfast daily, to help decrease inflammation.

Herbs

Herbs are generally available as standardized, dried extracts (pills, capsules, or tablets), teas, or tinctures/liquid extracts (alcohol extraction, unless otherwise noted). Mix liquid extracts with favorite beverage. Dose for teas is 1-2 heaping teaspoonfuls/cup water steeped for 10 - 15 minutes (roots need longer).

Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for inflammation, and for antioxidant and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Bromelain (Ananus comosus) standardized, 40 mg three times daily, for pain and inflammation.
Turmeric (Curcuma longa) standardardized extract, 300 mg three times a day, for pain and inflammation.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for inflammation.
Devil's claw (Harpagophytum procumbens) standardized extract, 100 - 200 mg one to two times daily, for inflammation.
Willow bark (Salix alba) standardized extract, 500 mg up to three times daily.

Capsaicin (Capsicum frutescens) Cream

Capsaicin is the main component in hot chili peppers (also known as cayenne). Applied to the surface of the skin, it is believed to deplete stores of a substance that contributes to inflammation and pain in arthritis. Several clinical studies have shown that capsaicin cream provided much better pain relief than a placebo but no improvement in joint swelling, grip strength, or function for people with OA. Pain reduction generally begins 3 - 7 days after applying the capsaicin cream to the skin.

Acupuncture

Several controlled clinical trials suggest that the ancient Chinese practice of acupuncture is an effective treatment for pain associated with OA, as well as for other aspects of the condition, including diminished joint function and reduced walking ability. In fact, a few clinical studies have shown that people with OA experience better pain relief and improvement in function from acupuncture than from NSAIDs such as aspiroxicam.

Chiropractic

Although there is no evidence that chiropractic care can reverse the joint degeneration that causes OA, some clinical studies indicate that spinal manipulation may:

Increase range of motion
Restore normal movement of the spine
Relax the muscles
Improve joint coordination
Reduce pain

A comprehensive review of the scientific literature suggests that chiropractic, especially when combined with glucosamine supplements and rehabilitative stretches and exercise, is an effective supplemental treatment for OA. Chiropractors will avoid using direct thrusts or pressure on red, swollen joints.

Physical Therapy

Physical therapy can be useful to improve muscle strength and the motion at stiff joints. Therapists have many techniques for treating OA.

Manual therapy and supervised exercise may decrease or delay the need for surgery in individuals with OA. In a trial evaluating physical therapy and exercise in people with OA of the knee, participants who received manual therapy to the lumbar spine, hip, ankle, and knees showed the following improvements:

Less stiffness
Reduced pain
Improved functional ability
Improved walking distance
Less need for knee surgery 1 year later

Magnet Therapy

Exposure to electromagnetic fields has boosted the number of cartilage-building cells and substances in laboratory experiments. One important study found that low-energy AC and DC magnetic fields stimulated the production of cartilage. For therapeutic purposes, users can apply magnets in one of two ways: directly to the skin surface over the bone or joint (capacitive coupling) or via pulsed electromagnetic fields (PEMFs) which induce an electrical current in the target tissue without making direct contact to the body (inductive coupling).

Clinical studies using either type of magnet therapy for arthritis are limited, and the few that exist have used poor methods, making it difficult to draw any definite conclusions. However, in one study of 78 people with OA of the knee, magnet therapy (applied to the knee for 6 - 10 hours per day over a period of one month) significantly reduced pain as compared with placebo.

Balneotherapy (Hydrotherapy or spa therapy)

Balneotherapy is one of the oldest forms of therapy for pain relief for people with arthritis. The term "balneo" comes from the Latin word for bath (balneum) and refers to bathing in thermal or mineral waters. Sulfur-containing mud baths, for example, have been shown to relieve symptoms of arthritis. However, hydrotherapy, which can be performed under the guidance of certain physical therapists, is occasionally used interchangeably with the word balneotherapy. The goals of balneotherapy for arthritis include:

Improving range of joint motion
Increasing muscle strength
Eliminating muscle spasm
Enhancing functional mobility
Easing pain

Although balneotherapy is most often used for psoriatic or rheumatoid arthritis, some medical experts believe that it may be beneficial for OA as well. However, one large review of clinical trials found little evidence to support its use.

Ice Massage, Transcutaneous Nerve Stimulation (TENS), and Electroacupuncture

In a well-designed trial comparing the effectiveness of TENS, electroacupuncture, and ice massage for the treatment of knee OA, each of these methods were found to:

Reduce pain at rest
Reduce stiffness
Boost walking speed
Increase quadriceps muscle strength
Increase knee range of motion

TENS is a technique used by many physical therapists. When the nerve stimulation of TENS is applied to acupuncture points, it is called electroacupuncture.

Mechanical Aids

A variety of mechanical devices, called orthoses, are available for people with OA to help support and protect joints. Made from lightweight metal leather, elastic, foam, and plastic, orthoses allow some movement within the affected joint and do not restrict nearby joints. For example, splints or braces help align joints and properly distribute weight. Shock-absorbing soles in shoes can help in daily activities and during exercise. Physical therapists use these mechanical aids most frequently to treat arthritic hands, wrists, knees, ankles, and feet. Orthoses should be custom-fitted by a physical or occupational therapist.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following treatments to alleviate respiratory symptoms (such as those experienced from cystic fibrosis) based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

Although people with OA are best treated with an individualized homeopathic remedy chosen by a professional homeopath, several trials have found that some common homeopathic combinations may be at least as effective as conventional medications for OA. Potential remedies include:

A topical homeopathic gel containing comfrey (Symphytum officinale), poison ivy (Rhus toxicodendron), and marsh-tea (Ledum palustre)
A combination homeopathic preparation containing R. toxicodendron., Arnica montana (arnica), Solanum dulcamara (climbing nightshade), Sanguinarra canadensis (bloodroot), and Sulphur
A liquid homeopathic preparation containing R. toxicodendron, Causticum (potassium hydrate), and Lac vaccinum (cow's milk)

Other Common Homeopathic Remedies for OA Include:

Calcarea carbonica (carbonate of lime or calcium carbonate)
Bryonia (wild hops)
Graphites
Guaiacum

Mind-Body Medicine

Chronic pain and disability can make daily functioning difficult. A holistic approach to care in these clinical circumstances may positively affect both lifestyle and how one feels overall. Many people report that relaxation techniques, such as guided imagery and meditation, are an important part of comprehensive, holistic care, and help to alleviate pain and other symptoms of OA.

Yoga

This ancient Indian practice is well known for its physical, psychological, emotional, and spiritual benefits and is often recommended in the West to relieve musculoskeletal symptoms. In one clinical trial studying OA of the hand, the group practicing yoga showed significant decrease in pain and improved range of motion compared to those participating in non-yoga stretching and strengthening sessions. Certain yoga "asanas" (postures) strengthen the quadriceps and emphasize stretching, both of which benefit people with OA of the knee. People with arthritis should begin asanas slowly and they should be performed only after a warm up. Yoga is best performed under the careful guidance of a reputable instructor.

Tai Chi

This ancient form of classical conditioning practiced in China for centuries has been reported in clinical studies to produce a number of benefits, including the following:

Improved fitness
Increased muscular strength
Enhanced flexibility
Reduced percentage of body fat
Diminished risk of falls in the elderly

In a clinical trial of subjects with OA of the knee or hip (ranging in age from 49 - 81), those who practiced tai chi twice a week for 3 months showed significant improvement compared to those in the control group in the following areas:

Overall sense of quality of life
Diminished feelings of stress/tension
Increased satisfaction with general health
Decreased fatigue
Easier self management of arthritis symptoms

Other Considerations

Pregnancy

Many of the herbs used in treatment for OA have not been tested on pregnant women and some are known to be unsafe for women who are pregnant. For this reason, pregnant women should take substances for pain and other symptoms only under the supervision of their obstetrician.

Prognosis and Complications

Complications of OA include:

Inability to walk due to very advanced hip or knee OA
Gastrointestinal bleeding and decreased kidney function resulting from long-term NSAID use

Many people are able to control OA and prevent the condition from worsening over time. Joint deterioration in OA tends to be slower than that of rheumatoid arthritis, but knee OA is still the number one cause of disability in industrialized countries such as the United States. Increased fluid in joints and joint enlargement occur later in the course of the disease. In the most advanced stages, OA can cause full cartilage loss. In some cases joint replacement may become necessary. While OA can be a debilitating condition, current treatments have shown great promise in reducing pain and improving mobility.

Supporting Research

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Review Date:
11/30/2007
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, NMD, private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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