Diarrhea

Diarrhea, frequent passage of abnormally loose, watery stool. Diarrhea usually develops suddenly and may last from several hours to a few days. It is often accompanied by abdominal pains, low fever, nausea, and vomiting. If the attacks are severe or increasingly frequent, exhaustion and dehydration can result. In normal digestion the large intestine absorbs excess water from liquid food residues produced by earlier phases of the digestive process before excreting semisolid stools. When the mucous membrane lining the large intestine is irritated or inflamed, food residues move through the large intestine too quickly and the resulting stool is watery because the large intestine cannot absorb the excess water.

Diarrhea is not a disease. It is a symptom of numerous disorders, such as food poisoning from contaminated foods or beverages, infections by viruses and bacteria, or anxiety. Chronic diarrhea, which lasts weeks or months, may be caused by amoebic dysentery (intestinal infection), tumors, and other serious intestinal disorders such as Crohn’s disease, ulcerative colitis, or irritable bowel syndrome. Except in the case of irritable bowel syndrome, the stool may contain blood or pus.

The usual treatment for diarrhea consists of bed rest, drinking liquids to replace fluids and salts lost from the body, and eating soft foods. Dehydration is a serious concern in infants and the elderly. If the condition lasts more than a few days, a physician should be consulted.

Myxedema

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Myxedema (Greek myxa, “slime”; oidema, “swelling”), deficiency disease caused by insufficient or lack of production of hormone by the thyroid gland. Patients with myxedema complain of fatigue, lethargy, sleepiness, poor tolerance to cold, mental sluggishness, a tendency to gain weight, and generalized aches and pains. Their faces often look puffy and waxy. Their skin is dry and coarse; their hair is coarse, dry, and brittle, and it tends to fall out easily. Often patients also lose the outer portion of their eyebrows. These and other symptoms are caused by a low metabolic rate resulting from a deficiency of the thyroid hormone that stimulates metabolism. Myxedema differs from cretinism in that it develops after birth and produces less severe cerebral inadequacy. The disease may occur in several members of a single family. Any condition that decreases the elaboration of thyroid gland hormone may bring on myxedema. The disease is treated by the administration of thyroxine, other thyroid extracts, or a synthetic preparation such as levothyroxine.

Goiter

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Goiter, disease of the thyroid gland, characterized by an enlargement of the gland, visible externally as a swelling on the front of the neck. In simple goiter the basal metabolic rate is somewhat lowered, and in toxic goiter it is elevated.

Iodine deficiency in the body can cause goiter. Treatments include the ingestion of small doses of iodine, or, in extreme cases, the removal of the thyroid gland.

SIMPLE GOITER

This condition is characterized by an enlargement of the entire gland, or of one of its two lobes, caused by a deficiency of iodine in the diet. The disease is especially apt to appear in adolescence. Prevention requires taking small doses of iodine for long periods. Ingestion of iodine during pregnancy prevents development of the disease in the infant as well as in the mother. Public health measures, including the addition of iodine to water supplies and to table salt, have helped to reduce the incidence of simple goiter in certain areas. Iodine is most effective when administered to children who have the disease. Thyroidectomy, or surgical removal of the gland, may be necessary in cases in which the gland has become greatly enlarged.

TOXIC GOITER

This disease, also called exophthalmic goiter, hyperthyroidism, thyrotoxicosis, or Graves' disease, for the Irish physician Robert James Graves, is caused by an excess of thyroxine secretion. The cause of the excessive secretion is obscure. In some cases it may result from excessive stimulation by the pituitary gland. The symptoms of toxic goiter may include a rapid heartbeat, tremor, increased sweating, increased appetite, weight loss, weakness, and fatigue. Some patients have eye problems, such as staring or protrusion. Thiouracil and iodine are sometimes used in the treatment of toxic goiter, as is irradiation of the gland by radioactive iodine.

See also Myxedema.

Disorders of Human Teeth

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The three main diseases of human teeth are tooth decay, also called dental caries; gum disease, or periodontal disease; and problems with tooth alignment, called malocclusions. Human teeth problems are treated or prevented by dentists, professionals who are specially trained to practice dentistry.

Tooth decay affects approximately 90 percent of all children by the time they are 14 years old. Tooth decay begins when bacteria are passed from mothers or caregivers to children between their first and second birthdays. When these bacteria are exposed to sugars commonly found in foods, the bacteria produce harmful acids that attack tooth enamel. Left unchecked, the acid eats holes in the enamel and forms cavities of tooth decay. Most tooth decay forms in the deep grooves on the chewing surfaces of the molars, called pits and fissures. Daily tooth brushing and proper dental care help prevent and reduce tooth decay. Dentists use preventive treatments to reduce the risk of tooth decay; clear plastic coatings painted on the teeth, called dental sealants, and applications of the mineral fluoride, which fortifies tooth enamel, are two such treatments.

Gum disease, or periodontal disease, is a progressive condition that worsens with age. Gum disease occurs when bacteria eat away at gum tissue, causing it to pull away from the teeth. This space between the tooth and gum, called a periodontal pocket, traps even more bacteria. Gum disease develops in two stages. Gingivitis, the early stage, causes red, swollen gums that bleed easily. Gingivitis can be eliminated through good oral hygiene and dental care. If not treated, gingivitis can progress to periodontitis, when bacteria attack the bone supporting the teeth. To treat periodontitis, dentists may have to surgically cut out the infected portion of the gum so the bacteria can be removed.

Malocclusions—teeth that are crowded, crooked, or out of alignment—make it more difficult to clean teeth, which can lead to other oral health problems such as tooth decay and gum disease. Many of these disorders start to appear between the ages of 6 and 12, when permanent teeth begin to erupt. Generally, malocclusions result when the jaw is too small to hold all of the teeth. Malocclusions are often genetic, tending to run in families. In other cases, dental injury or chronic thumb sucking may lead to poorly aligned teeth. Malocclusions are treated by dentists specially trained to correct them, called orthodontists.

Disorders of the Urinary System

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Urologists are physicians who specialize in treating urinary system disorders. One of the most serious disorders urologists treat is renal failure, which slows or stops the filtration of blood, causing toxic waste products to build up in the blood. Acute renal failure, which occurs suddenly, may be caused by bacterial infection, injury, shock, congestive heart failure, drug poisoning, or severe bleeding following surgery. Treatment may include drugs to address the underlying cause or to stimulate proper kidney function, blood transfusions, surgery, or, in some cases, kidney dialysis, in which the blood is mechanically filtered.

Chronic renal failure is a progressive deterioration of kidney function over a long period of time. It can be caused by diseases such as hypertension, diabetes, lupus erythematosus, acquired immunodeficiency syndrome (AIDS), and a form of cancer called myeloma. If diagnosed early the degenerative process can be slowed, but not reversed, by interventions that can range from simply restricting fluid intake and protein consumption (proteins are the main source of waste products) to taking drugs to address the underlying disease that is damaging the kidneys. Some patients may go on to develop end-stage renal failure, a life-threatening condition that requires long-term dialysis or a kidney transplant.

Urinary calculi, commonly known as kidney stones, result from the gradual buildup of crystallized salts and minerals in the urine. Kidney stones can cause intense pain if they obstruct a passageway that carries urine. Usually, the stones pass through and out of the urinary tract on their own. If they fail to pass out of the body, they can be removed surgically or broken up nonsurgically by an ultrasound technique called lithotripsy.

Bacterial infections, most frequently caused by the common intestinal bacterium Escherichia coli, can occur in any part of the urinary system. Antibiotics usually conquer the infection, although recurrent and chronic infections are not uncommon.

Among the many inherited and congenital disorders of the urinary system are polycystic renal diseases, in which numerous cysts form in the kidney, reducing the amount of functioning renal tissue. Kidney dialysis or transplantation usually is necessary to avoid kidney failure and death. Hypospadias is a birth defect in which the male urinary opening is misplaced on the penis; it may be under the head of the penis or as far away as the scrotum. Surgery before the child reaches 24 months can correct the defect, permitting normal urination and, later, sexual intercourse.