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Ear, Nose & Throat

Dr. Lim Keng Hua

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Tonsillitis: Everything You Need to Know Tonsils are the two structures on each side at the back of your mouth. They act as a defence mechanism, preventing your body from becoming infected. Tonsillitis is a condition when an infection develops on your tonsils.Tonsillitis is a common childhood infection but it can strike at any age too. It is most commonly diagnosed in youngsters, from preschool to mid-teens. Symptoms include a sore throat, swollen tonsils, pain swallowing and fever.Tonsillitis may be caused by both viruses and bacterial. Streptococcal bacteria is one of the most common cause of tonsillitis. Streptococcus tonsillitis is contagious. Without proper treatment, streptococcal tonsillitis can progress to cause significant complications such as a damage heart valve.What are enlarge tonsils?The medical term for constantly swollen tonsils is tonsillar hypertrophy. Tonsils are a vital element of your immune system and aid in the battle against illnesses caused by bacteria, viruses, and other pathogens that enter your body via your nose and mouth.Enlarged tonsils may indicate infection or inflammation caused by substances such as smoke or contaminated air. Specific individuals are born with bigger tonsils. In other instances, the cause is unknownTonsillar hypertrophy is more prevalent in youngsters, though it can also occur in adults. Children's tonsils are often larger than adults' because their bodies constantly battle colds and other diseases associated with childhood. As children get older, their large tonsils frequently shrink on their own.When the tonsils are enlarged, a range of symptoms can occur. They may obstruct the airway to cause snoring and sometimes sleep issues. Common sleep issues include partial airway obstruction, which leads to restless sleep, frequent awakenings, and even sleep apnea. They can also cause difficulty swallowing foods and bad breath.Enlarged Tonsils SymptomsTonsil enlargement does not necessarily result in symptoms. However, if they are particularly huge, they can partially obstruct your throat, impairing your ability to breathe.Additional signs and symptoms of enlarged tonsils include the following:breathing difficulties through the noseobnoxious breathingsnoring loudlysleepless nightspersistently runny noserecurrent infections of the ears or sinusesthe inability of young toddlers to eatsmelly breathCauses of enlarged tonsils in adults?There is no one-size-fits-all explanation for tonsillar hypertrophy. However, some experts feel that second-hand tobacco smoke and air pollution may contribute to larger tonsils.Viruses such as adenovirus, influenza virus, and herpes simplex virus are all possible causes of tonsillar hypertrophy. Tonsillitis may be caused by bacteria such as Neisseria gonorrhoeae, mycoplasma, or Haemophilus influenzae Type B.Infections with fungi or parasites, are uncommon. They also result in enlarged tonsils in adults. Tonsil Enlargement: Treatment and SurgeryAntibiotics are used to treat tonsillar and adenoidal bacterial infections. Once treatment begins, it is critical to complete the entire course of antibiotics as prescribed, as skipping doses might result in regrowth of the bacteria and risk of antibiotic resistant bacteria. Surgical removal if medical therapy is ineffective or in cases of recurrent tonsillitis.Medical experts frequently manage viral tonsillitis or swollen adenoids with supportive treatment (hydration and fever control) and over-the-counter pain medications. Avoid giving aspirin to a kid or adolescent unless prescribed by a physician owing to the risk of developing Reye's syndrome. Antibiotics are ineffective against viral tonsillitis.On the other hand, surgical procedures such as tonsillectomy and adenoidectomy may be indicated for those who experience recurrent or persistent infections, particularly if they impair daily activities. Tonsillectomy and adenoidectomy may also be indicated in cases when tonsil and adenoid hypertrophy has resulted in significant sleep disturbances (snoring and breath-holding), sleep apnea, dental abnormalities, and difficulties swallowing. Either alone or in conjunction with tonsillar hypertrophy, Adenoid hypertrophy can result in nasal obstruction, recurrent ear infections, or sinusitis. If these issues persist despite medical treatment, surgery may be necessary to resolve them. Enlarged Adenoids in Adults when to consult a Doctor?Typically, the adenoids grow in response to the body's attempt to combat illness. They can continue to grow even after the infection has cleared. However, most adenoids regress and are almost absent in most adults.Some children are born with larger adenoids. Allergies might also contribute to this expansion.Although it is uncommon, people might develop larger adenoids due to a prolonged illness or allergy, pollution, or smoking. Even rarer are swollen adenoids caused by a malignant tumour.Because people cannot see the adenoids when they look into their mouths, they cannot tell if they are swollen.A physician can examine the enlarged adenoids in adults with the aid of a unique mirror or illuminated camera attached to the end of a flexible tube (nasoendoscope).Consult your physician if you have any of the following:Sore throat for more than two daysFever greater than 38.5 degrees CelsiusDiscomfort or discomfort during swallowingBreathing difficultiesSwollen or painful tonsilsCan we prevent Tonsillitis?To decrease your risk of acquiring tonsillitis, you should take the following steps:Hands should be washed frequently, particularly before contacting your nose or mouthAvoid exchanging food, beverages, or utensils with a sick personChange your toothbrush consistentlyFinal WordsChildren and adults alike are at risk of developing tonsillitis, a common illness.Mild tonsillitis may go away on its own within a few days without the need for medication. Various home cures and over-the-counter medications can be used to alleviate some of the discomforts.Side effects from a simple case of tonsillitis are possible. New symptoms or worsening of existing symptoms should prompt a trip to the doctor.

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Ear, Nose & Throat

Dr. Lim Keng Hua

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Blocked Ear: Is There a Solution? When your ears are plugged, it may be due to a blocked eustachian tubes, a tube which connect your middle ear to the back of your nose. You may also experience a sense of fullness or pressure in your ears. Symptoms such as earache, dizziness, and distorted hearing are all possible. Normally, the blockage resolves as the swelling of the tube subsides.To unblock your eustachian tubes, try swallowing, yawning, or chewing sugar-free gum. If this does not work, take a deep breath and gently blow out of your nose while squeezing your nostrils and lips closed. If you hear a popping sound, you've succeeded.What is a Blocked Ear and how would I know?A blocked ear or ears can be a significant inconvenience and, in some cases, a health risk. Blocked ears can distort and muffle sounds, impairing your ability to hear your surroundings. Not only is having blocked ears annoying, but it is frequently accompanied by other symptoms such as ear pain, ringing in the ear, or dizziness.Ear Blockage: Causes and SymptomsThe following are symptoms: associated with ear block.A sensation of fullness in the earEar pain.Hearing impairmentEar ringing (tinnitus).Ear discharge or odour.Dizziness.Various factors can cause a blocked ear; surprisingly, it is not always due to ear wax. Although there are numerous reasons for an ear to become blocked, we highlight the five most common reasons:Eustachian Tube Dysfunction (ETD)The eustachian tube is a small canal (approximately 1.5 inches long and a few millimetres in diameter) that connects either ear (from the middle ear) to the back of the nose, an area known as the nasopharynx. The eustachian tubes remain closed most of the time; however, they will open when a person chews, yawns, or swallows. These tubes are responsible for balancing the pressure between the middle ear and the environment.Otitis Media (Middle Ear Infection)The middle ear is a susceptible area of the ear. Behind the eardrum is an air-filled space known as the middle ear. It contains ear bones (also known as ossicles) that responsible for transmitting sound from the outer to the inner ear.Occasionally, nasal congestion (due to illnesses, sinus infections, or allergies) can cause the eustachian tubes to close, resulting in fluid build-up and inflammation in the middle ear. Additionally, a bacterial sinus infection can spread to the middle ear, resulting in swelling, fluid accumulation, and disease. This is referred to as otitis media and is frequently accompanied by ear pain and pressure.Earwax Obstruction or BlockageEarwax is a naturally occurring substance that coats the ears and protects them from water, bacteria, fungi, and other elements. It keeps the ears lubricated and clean; however, occasionally, excessive earwax accumulates, causing problems.Typically, earwax produced by the ear moves outwards to the ear canal opening and falls out. However, some individuals may produce excessive ear wax, too much for the body to clear spontaneously, eventually affecting the hearing. As earwax accumulates over time, it may harden and become difficult to remove, making ears more susceptible to blockages. Self cleaning with cotton buds sometimes worsening the situation.Otitis Externa (Swimmer's Ear)Otitis Externa, also known as swimmer's ear, is an infection or inflammation of the external ear canal, i.e. the canal between the eardrum and the outer ear. This is frequently triggered by exposure to water or excessive ear cleaning. Apart from hearing loss, this condition may cause pain, itchiness, smelly ear discharge, pus in the ear canal, and buzzing or humming noises in the affected ear. Otitis externa may be due to a fungal or bacterial infection. Antibiotics or antifungal medication are prescribed. Ear cleaning to remove the pus and discharge aids recovery. Barotrauma (Aeroplane Ear)When the pressure inside your ear differs from the pressure outside your body for an extended period, severe damage to your eardrum can occur. This type of injury is referred to as barotrauma. It is frequently encountered by those who scuba dive, fly often, and drive or hike at high altitudes—barotrauma results in ear pain, dizziness, and a pressure sensation in the ears. Severe barotrauma can result in the rupture of the eardrum, hearing loss, and nose bleeds.What can you do about clogged ears and ringing in your ears?There are several treatments if your ears feel clogged and ringing. However, you should consult a physician before and following any attempt to remove earwax or a foreign object. Doctors may conduct a hearing test, especially if the patient reports a hearing loss. If the individual's hearing does not return following the removal of the blockage, the blockage (or previous attempts to remove it) may be due to causes arising from the middle or inner ear. Earwax removalThe ear wax may be removed by the doctor using the following methods.Earwax Curette - an instrument with a loop at the end—to remove earwax.Flush the ear with a syringe and water.Suction apparatus and a microscopeExpungement of a foreign objectAn otolaryngologist (an ear, nose, and throat doctor) will be able to remove all foreign objects from the ear canal. The otolaryngologist carefully removes the foreign body using a microscope and specialized tools. The doctor may use a small, blunt hook or a small vacuum device to remove the foreign objects. Small alligator forceps can remove objects with an edge (such as a strand of hair).Elimination of an insectInsects, such as cockroaches or beetle, can enter and obstruct the ear canal. To kill the insect, the doctor introduces either lidocaine (a numbing agent that provides immediate pain relief) or alcohol solution into the ear canal (if the eardrum is intact). The insect dies after a few minutes, allowing the doctor to remove it without further injuries by the insect.Pressure in Ears Won't Go Away for a month: What Should I do?There are numerous reasons for pressure to build up in the ears, ranging from altitude changes to ear infections. Occasionally, it is simple to relieve the pressure, but it may take longer in other occasion.Individuals can first attempt to pop their ears open via the eustachian tube to alleviate pressure. They can achieve this by:chewing gumyawningscreamingswallowingwiggling the jawgently exhaling against a closed airway (Valsalva maneuver)Sucking on hard candy, such as a lollipop, can be a gentle way to keep the ear tubes open. Sucking on a bottle or pacifier can have the same effect on a baby.Individuals can attempt to prepare before engaging in an activity that increases ear pressure. For example, it may be beneficial to begin wiggling the jaw before boarding a plane to give the ears additional time to adjust to the outside (atmospheric) pressure. Similarly during a plane descent, start equalising the ear early to prevent blockage.Treatments for ear pressure can be either preventative, such as for someone about to fly, or curative, such as for those who have blocked ears that they cannot pop.If a patient has a history of ear problems, a doctor may prescribe preventive treatments.Persistent ear block due to middle ear fluid may be the presenting symptoms of nasopharyngeal cancer. Hence, when in doubt, please consult a doctor early.Is there an over-the-counter medicine or remedy?For those with mild to moderate symptoms, over-the-counter (OTC) nasal sprays and decongestants can help to alleviate ear pressure. Oral pseudoephedrine is one such exampleOTC options are appropriate for air travellers before a flight. However, they should not be used excessively, as prolonged use can result in complications.For example, if a person uses decongestant nasal sprays excessively over a period of time, they may cease to provide relief and instead exacerbate congestion.When to seek medical help?It's critical to recognise when it's time to visit your doctor and have it checked, just in case the symptoms are due to something more serious.In the event that you experience any of the following symptoms, please contact your doctor immediately:The symptoms did not improve within three daysWhen the body temperature exceeds 38-degree celsius, a fever may accompany it, indicating a more severe infection. Ear infections are a common occurrence. They can eventually result in hearing loss.When a child is younger than six months old, and the symptoms of an ear infection are present.Pus, bloody or a smelly fluid is discharging from the ear.The discomfort become worsen especially when other symptoms such as vomiting, headaches, a stiff neck, drowsiness, and a loss of balance are present.Persistent ear block for more than 2 weeks without resolution. Final WordsWhile blocked ears can be unpleasant, bothersome, and uncomfortable, they typically resolve spontaneously or with appropriate medical intervention. Seek help if the ear block is persistent, or associated with pain, ear discharge or fever.

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Dr. Alvin Ng Kok Heong

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Chronic Kidney Disease vs. Kidney Failure: What you need to Know? Your kidneys perform various crucial roles in your overall health. One of its most crucial functions is to filter waste items from the blood and excrete them via urine. The kidneys also have other important functions including regulating water, salt and minerals in the body to ensure they are in equilibrium. It also plays a significant role in maintaining the blood pressure, activating vitamin D and aid in stimulating the production of red blood cells through complex hormonal pathways. The Difference Between Chronic Kidney Disease and Kidney Failure“Chronic kidney disease” refers to an abnormality in the kidney function. This is detected by a blood or urine test or detected from scanning the kidneys. These tests will be repeated to confirm the condition and to ensure that we can track the changes of the kidney function over time. The are many causes of chronic kidney disease and the most common causes are diabetes mellitus and hypertension. Other causes would be inherited diseases (Fabry’s disease, polycystic kidney disease), kidney inflammation (glomerulonephritis), and cancer (myeloma). Chronic kidney disease can be categorised to mild, moderate, severe and end-stage. Over time, the kidney function may deteriorate, especially if the person does not seek early treatment. This deterioration can range from months to years or even in decades. If the damage is severe enough, your kidneys may cease to function. This condition is referred to as kidney failure or end-stage renal disease (ESRD). If your kidneys fail, the only treatment available to maintain life is dialysis or a kidney transplant. What are the first signs and symptoms of Chronic Kidney Disease?In the early stages of chronic kidney disease, there are typically very few symptoms. You should look out for foamy or bubbling in your urine, change in colour of your urine (turning red or dark brown in colour), if you pass small amounts of urine or notice you are urinating less frequently. More than 80-90% of the time, you would not have symptoms. Therefore, chronic kidney disease is detected during health screening tests which would include a blood or urine test. Your doctor would routinely repeat these tests, and will refer you for a review with a kidney specialist. However, if your kidneys have severe failure, you may notice one or more of the following symptoms:tirednessswelling in ankles, feet, or hands.shortness of breathnausealack in appetiteheadachechanges in urine (colour, blood, bubbly urine, reduced frequency or volume).What are the 5 stages of kidney failure?Chronic kidney disease (CKD) is classified into five stages, ranging from very mild damage in stage 1 to kidney failure in stage 5. The stages determine the estimate function of your kidneys and it’s ability to carry out it’s role in filtering waste products, maintaining water and salt balance, and normal blood pressure, blood count and vitamin D levels.The estimated glomerular filtration rate (eGFR) is derived from your blood test for creatinine, your age and gender.Chronic kidney disease stage 1 (CKD)eGFR 90 or more Kidney damage with normal eGFRWhile this typically indicates that the kidneys are healthy and functioning normally, there are other indicators of kidney impairment, such as protein in the urine or structural damage to the kidneys (e.g. scarring in kidneys, kidney cysts, kidney stones, single kidney).Chronic kidney disease stage 2 (CKD)eGFR between 60 and 89Kidney damage with mild decrease in eGFRStage 2 generally indicates that the kidneys have lower functioning status but will not cause any significant symptoms. Chronic kidney disease stage 3 (CKD)eGFR of 30 and 59 is further divided into two stages.Stage 3a is defined as an eGFR of 45 to 59.Stage 3b is defined as an eGFR of 30 to 44.Moderate decrease in kidney functionWhile symptoms may not be apparent at this stage, you may experience changes in urination (reduced frequency, volume, changes in colour of urine, bubbling in urine) or swelling in the hands and feet, or back pain.Complications of the disease such as high blood pressure, low blood count and bone disease causing pain are possible.Chronic kidney disease stage 4 (CKD)eGFR between 15 and 29Severely decreased kidney function.This is a critical stage: the final stage before renal failure.Stage 4 symptoms and health concerns are the same as stage 3.Patients with stage 4 renal disease should contact a nephrologist (kidney specialist) to plan for kidney failure, which may require dialysis or a kidney transplant.Chronic kidney disease stage 5 (CKD)eGFR 15Kidneys are nearing or have failed.When the kidneys fail, waste accumulates in the blood, making patients extremely ill.Itching, muscular cramps, nausea and vomiting, loss of appetite, swelling in the hands and feet, back discomfort, urinating less than average, difficulty breathing, and difficulty sleeping are just a few of the symptoms of kidney failure.Patients with renal failure should be prepared to initiate dialysis or receive a kidney transplant to survive. However, certain patients may choose to only take medications to control the symptoms of kidney failure.Types of kidney function tests and proceduresRenal abnormalities may not be recognised until specific tests to assess kidney function are performed. Here's everything you need to know about typical kidney function tests.Serum CreatinineCreatinine is a waste product made by your muscles and removed by the kidneys. It‘s level indicates the kidneys' ability to remove this product from the body. When your kidneys are not working well, creatinine will not be clearly properly leading to an abnormally high level.Estimate GFR (Glomerular Filtration Rate)The estimated glomerular filtration rate, or eGFR, is a more accurate test in determining your current level of kidney function. It is a formula which takes into the account of your age, gender, ethnicity and serum creatinine. This formula has been validated in our Singapore population and can be used to estimate the status of your kidney function. The value will indicate the amount of blood that is being filtered by the kidney every minute. UrinalysisA urinalysis is another frequently used test for determining potential problems with your kidneys. A urine sample is analysed and provides many information of the current state of your kidneys. The most important results for the urine sample are presence of red blood cells, white blood cells and urine albumin.If albumin is detected in the urine, this may suggest that the kidneys have been damaged. This disorder is due to the kidney cells leaking albumin into the urine instead of conserving it. If there is presence of red cells or white cells in the urine, it could indicate that you have a urinary tract infection, kidney inflammation (glomerulonephritis), kidney stones or tumour. Nitrogen Urea BloodThe blood urea nitrogen level (BUN) determines the amount of urea nitrogen in the blood. The blood urea nitrogen level is determined as part of regular blood work and is included in a metabolic panel. When this level is elevated, it likely indicates a kidney excretion problem. A physician will interpret the results of routine kidney function testing. If the results are abnormal, they may order further specialised testing, including the following:An ultrasonography of the kidneysUltrasounds use sound waves to create images of body parts. With a renal ultrasound, health care experts can determine whether the kidneys are blocked or scarred and whether there are any stones or cysts. It can also determine the blood flow supply fo the kidneys. A CT scan of the kidneysA CT scan is an imaging technology that doctors can use to check for blockages in the urinary tract, kidney stones, kidney tumours including benign tumour and cancerous tumours. A biopsy of the kidneyThis is a minimally invasive procedure, where kidney tissues are taking via a biopsy needle with the aid of ultrasound machine. The kidney samples will then be analysed under a microscope. This will provide important information about the underlying kidney condition, the severity of damage and other aid in the treatment of the condition. Final WordsChronic kidney disease is often silent until you lose 90% of the kidney function. It is advisable to undergo screening test as early as 30 years of age, especially if you have certain risk factors (e.g. suffer from diabetes, high blood pressure or have a family history of kidney disease). Once the kidney damage has occurred, it is not reversible. However, this condition can be treated with the aim to slow or halt the progression of the disease to end-stage kidney failure.

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Ear, Nose & Throat

Dr. Lim Keng Hua

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Sinusitis: Symptoms, Causes, and Treatments Sinusitis is an illness in which the paranasal sinuses become inflamed. Paranasal sinuses are air filled spaces in your face. Sinus cavities create the mucus that allows nasal passageways to function correctly. Sinusitis can be either acute or persistent. Inflammation in the sinuses can be caused by viruses, bacteria, fungus, allergies, or an autoimmune reaction. Sinusitis can be inconvenient and painful. If symptoms are severe and persistent, a person should see a doctor.What is Sinusitis?Sinusitis is when the tissue lining the sinuses becomes inflamed or swollen. It is essential to know that there are four pairs of sinus cavities (spaces) in the skull. Tiny passageways link them to the nose. The sinuses produce a thin mucus that flows into the nose's nasal passages. As a result of this outflow, the nose is kept free of microorganisms. It is possible for the sinuses to become obstructed and filled with fluids, which can be a source of infection if bacterial thrive. This is also known as bacterial sinusitis.Another name for this condition is "rhinosinusitis". "Rhino" refers to the "nose." Inflamed sinus tissue nearly invariably results in swollen nasal tissue.Common Symptoms of Sinusitis?Sinus symptoms can range according to the duration of a problem and the severity of the symptoms.Symptoms include the following:A nasal discharge that may be green or yellowfacial discomfort or pressurea sore throata cougha foul breatha feverheadachesa diminished ability to smell and tastepain and swelling around the eyes, nose, cheekbones, brow a toothacheWhat is Sinus Headache and Sinus Infection?Sinus headaches are headaches that may feel as if caused by a sinus infection (sinusitis). You may have pressure in the area around your eyes, cheekbones, and brow. There may be a throbbing discomfort at the back of your skull.However, many patients who believe they have sinusitis-related headaches, including those diagnosed, have migraines instead.On the other hand, a sinus infection, medically referred to as sinusitis or rhinosinusitis, happens when the nasal cavities become infected, swollen, and inflamed. Mucus accumulation in the sinuses can promote the growth of germs, resulting in a sinus infection, as known as sinusitis.Sinusitis is most frequently caused by a flu virus which persist after the other upper respiratory symptoms have resolved. Bacteria — or, more rarely, fungi — may cause a sinus infection in some situations. Sinus pain and symptoms can also be caused by other illnesses such as allergies, nasal polyps, and tooth infections.Sinus Pressure: What Can You Do to Feel Better?When you're congested, your primary goal should be to keep your nasal passages and sinuses moist. Although some individuals believe that dry air can help clear up a runny nose, this is not the case. Drying out the membranes aggravates their irritation.You can do the following to keep your nasal passageways moist and prevent sinus pressure:Employ the use of a humidifier or vaporiser.Shower for an extended period or inhale steam from a pot of warm water. The water should not be too hot to avoid being scalded.Consume plenty of fluids. This will thin your mucus, potentially preventing blocked sinuses.Utilise a saline nasal spray. It's saltwater, and it will assist in keeping your nasal passages moist.Face your face with a warm, moist towel. It may alleviate irritation and aid in the opening of your nasal passages.Prop yourself up with a couple of pillows. Elevating your head may make breathing easier.Steers clear of chlorine pools. They have the potential to irritate your nasal passages.Blow your nose gently to avoid blowing into your ears or other regions of your sinuses, and into a disposable tissue to avoid spreading germs. Wash your hands after that.Different kinds of Sinus Infections and their TreatmentsAcute SinusitisAcute sinusitis is the shortest-lasting kind. It may be caused by a viral infection such as a common cold. Symptoms usually last between one and two weeks. Acute sinusitis, caused by a bacterial infection, can last up to four weeks. Subacute SinusitisSymptoms of subacute sinusitis can continue for up to three months. This is a typical complication of bacterial infections and seasonal allergies.Chronic sinusitis (Sinusitis that persists)The symptoms of chronic sinusitis last longer than three months. They are frequently less severe. It may be due to a bacterial infection. Chronic sinusitis is commonly associated with chronic allergies or nasal structural abnormalities.There are various treatment options for sinus infections. A few of them are the following:AntibioticsAntibiotics are frequently used to treat bacterial sinus infections. Antibiotics are typically used for between three and twenty-eight days, depending on the type of antibiotic. Patients with more severe or prolonged illnesses may require longer treatments.Nasal Decongestants SpraysNasal decongestants used topically can be beneficial in relieving if blocked nose, provided it is not used for more than 5 days. These drugs constrict enlarged nasal tissue, allowing drainage from the sinuses to flow more freely. Excessive usage of topical nasal decongestants might result in a dependent condition known as rebound phenomenon, in which the nasal airways swell shut.AntihistaminesAntihistamines inhibit the inflammation induced by an allergic reaction, aiding in treating allergy symptoms such as swollen nasal and sinus passages.Decongestants and antihistamines for the nosePrecautions should be exercised when using over-the-counter combination medications. Several of these medications contain drying agents that might cause mucus to thicken. Use these only as directed by your allergist.Nasal corticosteroids on a topical basisThese prescription nasal sprays work by preventing and reversing inflammation and swelling in the nasal passages and sinus openings, the primary sinus infection symptom. Nasal corticosteroid sprays applied topically are also efficient at shrinking and preventing the recurrence of nasal polyps. At the recommended dose, these sprays are not absorbed into the bloodstream. They can be used for an extended period without creating "addiction".Saline nasal cleansesNasal rinses can assist in clearing the nasal passages of viscous secretions.SurgerySurgery may be recommended as a last option if pharmacological therapy has failed. Typically, an otolaryngologist performs this procedure. Anatomical abnormalities are corrected to improve the sinus out-flow tractsWhen to Seek Medical CareYou should seek medical attention if you are experiencing the following:a temperature greater than 102°F (38.8°C)vision issues or double visionsevere pain and persistent headachessinusitis that persists for more than 12 weeksconfusionstiff neckHow Do You Get Rid of a Sinus Infection?To begin, you must determine the source of the sinus infection. Is it a viral or bacterial infection? If the condition is viral, it should persist no more than two weeks. Nasal decongestant sprays, oral and topical antihistamines, nasal steroids, and nasal saline washes can all be used to alleviate sinus infection symptoms. Antibiotics are typically prescribed to treat bacterial infections. However, exercise caution here. Avoid prescribing antibiotics prematurely.Over-the-Counter Medicine for Adult and ChildrenMedications that are available without the need of a prescription may help reduce discomfort and stimulate sinus discharge. Take precautions when taking medications. Read and obey all label instructions. You can:Alleviate facial pain and headaches, take acetaminophen or ibuprofen.Use a nasal spray, gel, or drops to alleviate a stuffy nose. There is a decongestant type (such as Afrin, Dristan, or Neo-Synephrine) and a steroid type (such as Nasacort,Aavamys or Nasocort). Use the decongestant kind only for the duration specified on the label. Excessive use can result in rebound congestion. It causes your mucous membranes to swell more than they did before using the spray.If you have a congested nose or head, try an oral decongestant. It provides longer-lasting comfort than those administered in the nose but may have more significant adverse effects.Utilise a medication that thins mucus and aids in sinus outflow (mucolytic). Guaifenesin is a mucolytic that is frequently used. Mucolytics are commonly prescribed with other medicines, such as cough suppressants.Acetaminophen is available in a variety of dosage formulations.Take precautions when taking medications. Read and obey all label instructions.Take no more than the maximum suggested dose on the label.Take caution while taking over-the-counter cold or flu medications in conjunction with acetaminophen (Tylenol). Acetaminophen is already included in a number of these medications. Acetaminophen in excess might be hazardous.How to Prevent Sinusitis?Keep your allergies under control. Avoid irritants to the nasal passages such as smog and smoke. Regularly flush your sinuses with a saline sinus wash (from once a day to once a week for some). Use oral probiotics, particularly after medications, to replace the sinuses' natural biome.Final WordsSinusitis, or inflammation of the sinus cavities' tissues, is a frequent problem caused by a variety of factors, including viruses and bacteria, nasal polyps, or allergies. At home, you can relieve symptoms by relaxing, using over-the-counter medications, and increasing your hydration intake. Contact your healthcare provider if your symptoms do not improve, if sinusitis occurs frequently, or if you have any other concerns.

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Dr. John Hsiang

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Facts about Chronic Constipation Some people find constipation to be an absolutely miserable condition. Not only does it make you feel bloated and irritable but just trying to relieve this common digestive complaint can take up your whole day or even weeks if necessary! Chronic cases lead to 2-5 million doctor visits every year in America alone--and those numbers continue rising as time goes on with no end in sight for these pain levels deriving from a lack of movement throughout our digestive system (including stool). Chronic constipation can be a challenging condition to deal with. For some people, it means they have infrequent bowel movements that last weeks at a time, while others mean having difficulty passing stools or straining during defecation, which results in small bowel movements (or none). Chronic Constipation: Symptoms and Causes Wouldn't it be simple if you could pinpoint the source of your chronic constipation? Although this is not always the case, your inconsistency in passing bowel motions may indicate one or several causes. Continue reading to discover what your intuition may be communicating to you and what you could do about it. Here are the main symptoms of constipation: difficulty in passing stool pain around the anus while passing stoolpassing small amount of stool than usualfaeces that is lumpy, dry, or hardIt may also include other symptoms such as:abdominal discomfort and crampingabdominal bloatingnauseaa decrease in appetite Listed below are possible causes of constipation: Inadequate fibre in the diet Individuals who consume a high fibre diet are less prone to have constipation. Fibre promotes regular bowel motions, particularly when combined with enough hydration. About 1.5 to 2L a day is adequate for a 70kg person. Inactivity on the physical front Constipation may also be a result of insufficient physical activity. Several previous studies have discovered that physically fit individuals, such as marathon runners, are less prone to have constipation than the general population. At the same time, the precise causes for this remain unknown. For a normal person, a recommended regimen would be regular exercises about 3 times a week, 30-40 minutes each time Aging Constipation is more prevalent as people age. The precise reason for this is unknown. This may be related to neurodegenerative disorders, medications, and inactivity. As people age, food may pass through the digestive tract more slowly. Numerous people may have decreased mobility, which may add to constipation. Irritable bowel syndrome Individuals who suffer from functional intestinal difficulties, such as irritable bowel syndrome (IBS), are at a greater risk of constipation than those who do not. Excessive use of laxatives Specific individuals are concerned that they do not use the restroom frequently enough and take laxatives to address this concern. While laxatives can aid in bowel movements, prolonged use of certain laxatives acclimates the body to their action. This may result in a person continuing to use laxatives when no longer necessary. Additionally, the individual may require higher doses to achieve the desired effect. Insufficient hydration Consuming adequate water regularly can help lower the risk of constipation.Naturally sweetened fruit or vegetable juices and clear soups are sufficient fluids. Colorectal issues Certain medical conditions that impact the colon can obstruct and hinder stool flow, resulting in constipation. Several examples of such conditions include the following: malignant tumorsherniascar tissuecolorectal stricture, a condition in which the colon or rectum becomes abnormally narrowedinflammatory bowel disease (IBD)Pelvic floor dysfunction – where the pelvic muscles are not moving the proper way to expel the stool Is There a Connection with Back Pain and Constipation? Can constipation cause back pain? The answers are yes, and no. Lower back pain and constipation may be symptoms of the same illness or unrelated symptoms that occur concurrently. If these symptoms occur together, a person should seek medical attention. Lower back discomfort is common and generally resolves on its own. Constipation is also a regular occurrence, and it is typically treatable at home. Constipation might occur as a result of the source of lower back pain. This can occur because of a tumour or growth. Natural Home Remedies for Constipation You may be able to resolve your constipation problem independently without the assistance of a physician. While it may seem self-evident, your food significantly impacts how you poop. Consume more fibre. Fibre helps bulk up and soften stool, making it easier to pass. Raise the quantity of fibre in your diet progressively until you reach a daily intake of at least 20 to 35 grams. Whole grains found in cereals, bread, brown rice, legumes, veggies, and fresh or dried fruits are good sources. Prunes and bran cereal are time-tested cures for constipation. Maintain adequate hydration - Water is also necessary for constipation prevention. Consume at least eight glasses of water per day. Consider coffee - While caffeinated beverages and alcohol might dehydrate you, there is evidence that a cup of coffee or tea in the morning may aid in bowel movements. Avoid foods heavy in fat and lacking in fibre - Cheese, meat, and processed foods can only worsen constipation. There are also exercises for constipation. Simply standing and moving around can assist with constipation. A regular walking routine — even only 10 to 15 minutes many times a day — can help the body and digestive system function optimally. If you are already fit, you may choose to go for aerobic exercise such as running, jogging, swimming, or swing dancing. Final Words Chronic constipation may indicate a more serious health problem; thus, if you have not had a bowel movement in the last two to three weeks, visit your doctor or healthcare professional. Additionally, medical intervention may be necessary if you are suffering significant stomach pain or are concerned about the presence of blood in your obstructed stool. Consult your physician on approved home remedies for constipation and future constipation prevention.

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