Gastrointestinal Disease

Due to space constraint, we can only hold a brief discussion on the more common type of gastrointestinal diseases.

Gastrointestinal diseases otherwise referred to as irritable bowel syndrome (IBS) is often the cause of many health problems and sicknesses. Look after your Gastrointestinal health and many of your health problems will diminish.

At Beyond Medicine, we put great emphasis on Gastrointestinal health. As part of the examination, we routinely palpate the abdominal cavity for any signs of tenderness, discomfort or pain. It goes without saying that if there is any tenderness, discomfort or pain during palpation, there is invariably a problem with your Gastrointestinal health. Yet a scan will often produce a negative finding. Until and unless there are scar tissues or unless the problem is very acute, conventional scans will produce a negative finding. This can be very misleading and create false hope in a patient who knows that his/her abdominal health is in question. Considering the daily intake of processed foods, the preservatives that are added to our foods and the life style, no wonder there are many out there who suffer from one form of abdominal disorder to another.

Simply put, Gastrointestinal disorder is the cause of many types of pain. In our practice, we quickly learn that middle back pain can be a crossover of stomach problems, lower back pain can come from a problem with either kidneys or the bladder. Gall stones can cause pain to the right side of the back and so on. Therefore when a client comes in to see us complaining of back pain, our initial approach is to determine if there is a problem with the Gastrointestinal tract or the abdomen. No doubt, we will also examine the spine carefully for any symptoms of misalignment, muscles spasms and so on but abdominal health is top of the list!

When it comes to abdominal disorders, a patient would usually have experienced some sort of pain in the abdominal cavity. The abdominal pain can be stomach cramps, stomach ache, abdominal discomfort, heartburn, upper abdominal pain, kidney pain, liver pain or other related types of pain. In addition, there are discomforts caused by reflux, bloating and fluid retention.

Abdominal pain can range from severe life threatening conditions, for example aortic aneurysm, acute appendicitis to much less serious conditions such as heart burn, reflux and gastroenteritis. We would recommend prompt medical attention for any types of abdominal pain.

Abdominal pain is a very common symptom and many are not serious. Because they are not serious many cases of appendicitis in children are wrongly diagnosed as gastroenteritis. We have a way of distinguishing between appendicitis and gastroenteritis. On the other hand, certain types of Gastrointestinal problems such as helicobacter pylori, crohn’s disease and ulcerative colitis could lead to cancer. For this reason therefore, we would specifically make reference to them.

Abdominal pain can be classified into more specified types such as lower abdominal pain, upper abdominal pain, left abdominal pain, right abdominal pain and epigastric pain (pain behind the breastbone such as in heartburn, reflux or GERD or pain on the right side as caused by gallstones.



The following are some of the possible causes of abdominal pain. There could be other accompanying or possible causes so it is best to consult your doctor if in doubt. The list below is not exhaustive.

1. Gas
   
2. Gallbladder disease
   
3. Colon cancer
   
4. Diverticulitis
   
5. Diverticulitis
   
6. Appendicitis
   
7. Gastroenteritis
   
8. Food poisoning
   
9. Peptic ulcer
   
10. Kidney stones
    
11. Ovarian cysts
    
12. Stomach cancer
    
13. Acute pancreatitis
14. Intestinal obstruction
    

Helicobacter Pylori Infection:  This organism causes a spectrum of disease in humans including gastritis, ulcer disease (both gastric and duodenal) and in all probability, gastric cancer and gastric lymphoma. In all likelihood, helicobacter Pyloric Infection is one of the main causes of stomach cancer. Indigestion (dyspepsia) is a very common symptom and a very high proportion of people with indigestion will have helicobacter pylori infection causing gastritis. Up to 10% of the population will develop peptic ulcer disease at some time in their lives and most duodenal ulcers and many gastric ulcers are due to helicobacter pylori infection.


Conventional medicine will diagnose helicobacter pylori by biopsy with urea breath test. At Beyond medicine, we would palpate the abdominal cavity, especially, the right and left upper quadrants and the central midline posterior to the rib cage for any signs of discomfort, tenderness and pain to determine the presence of ulcers. If ulcers are suspected, the possibility of helicobacter pylori infection cannot be ruled out.

Hiatus Hernia:  The presence of a hiatus hernia is usually noted when a patient is in the process of lying down on our examination table face up. There is usually a bulge
between the oesophagus and the stomach. This bulge is very noticeable in severe cases. The junction of the oesophagus and stomach stays down within the abdomen and the top part of the stomach (the fundus) bulges up into the chest cavity.  Prolonged use of prescribed medication, excessive junk foods and extreme stress can cause it.

Hiatus hernia may cause or contribute to pain in the abdominal area, heartburns and pains in the chest area. However, there can also be symptoms of a number of other conditions such as peptic ulcers and even symptom of heart problems. Whenever there is a severe case of hiatus hernia, reflux, heartburn and symptoms of bloating are invariably present.

With enzyme therapy and certain exercises, we are able to help with the gradual reduction of the hiatus hernia and make it go away completely without surgical intervention.

Cirrhosis of the liver:  The term refers to advanced liver damage and which is characterised by dense scarring where the lobes are covered with fibrous tissues. Once cirrhosis develops, it is usually irreversible but further damage may be stabilised if the cause is removed or remedial actions taken. Cirrhosis are caused in the main by excessive alcohol consumption, iron overload, chronic viral hepatitis, autoimmune diseases, chronic bile duct obstruction. The symptoms would usually include yellowing of the skin, circulatory changes occasioned by reddening of the palms, spider veins in the chests, loss of libido and hair loss. In men, there could be breasts enlargement, testicular atrophy and impotence. In females, the symptoms may include irregular menses, absences of periods, breast atrophy. Bruising is also a symptom of cirrhosis, enlarged spleen and bleedings in the veins are common.

Hepatitis:  The term refers to an inflammatory process within the liver from whatever cause. The cause may be a virus, prolonged use of certain prescribed medication, a toxin, autoimmune related diseases which allows the immune system to attack one’s tissues. Hepatitis B & c can be chronic whilst hepatitis A is not of a chronic nature.

People with chronic hepatitis may feel quite unwell with symptoms of tiredness, loss of appetite, nausea, easy bruising and fluid retention. Clinical examination may reveal dilated blood vessels in the skin, redness in the palms, easy bruising, enlargement of the liver and spleen and fluid retention in the ankles. One must be well advised that hepatitis is highly contagious.

Crohn’s Disease:  The term refers to a chronic inflammatory process of the intestinal tract. The disease can be anywhere within one of the four parts of the intestinal tract which can be the oesophagus, the stomach, the colon and the rectum. However the two main primary sites for crohn’s disease are the ileum which is the last portion of the small bowel and the colon. The lining of the bowel can become ulcerated and thickened.
 

Symptoms of crohn’s depend on the position of its occurrence. Where the ileum is involved, there is usually pain in the right lower quadrant or where the colon is involved, there is usually pain posterior to the naval (belly button) But some sort of pain is usually felt during palpation. When the colon is the site of the infection, diarrhoea sometimes with bloody stool may occur with fever and weight loss. Crohn’s disease often affects the anal area where there may be a draining sinus tract called a fistula. When the disease is fully active, the patient may experience fatigue and feeling of lethargy may appear.

In conventional medicine, there is no once conclusive diagnostic test for Crohn’s disease. Patient’s medical history and physical examination are always helpful. Certain blood and stool tests along with colonoscopy are performed to arrive at a diagnosis. In addition, a sigmoidoscopy of the lining of the rectum and lower bowel is often required. At Beyond Medicine, the whole of the abdominal cavity is routinely palpated for symptoms of crohn’s. We find that we are by far more accurate because if there is tenderness, discomfort or pain during palpation, common sense suggests something is not quite right!  Outside the bowel, other problems can develop. These can include arthritis, eye and skin problems. Open sores outside and in the vicinity of the anus can develop and these are often painful. A fistula can also be formed.  Conventional medicine resorts to cortisone, anti-inflammatory drugs and pain killers to control the disease; surgical intervention to remove the infected part of the bowel is often the treatment of choice!

Ulcerative Colitis:  In the early stage, it is extremely difficult to distinguish between crohn’s and ulcerative colitis. The treatment for both remains the same. Ulcerative colitis involves the inner lining of the large intestine (colon or bowel) and rectum with a chronic inflammatory process. The small intestines are not involved.
The most common symptoms are abdominal pain and diarrhoea which may contain blood, mucus and pus. Patients may suffer fatigue, weight loss, dehydration and malnutrition. Colonoscopy or flexible sigmoidoscopy is the preferred method of diagnosis. Palpation of the lower abdomen would give us an indication as to whether or not the patient has ulcerative colitis.

It suffices to add that both crohn’s and ulcerative colitis would lead to bowel cancer.

Graves Disease

Grave's disease is a disease of unknown cause, although fairly common. It is suspected to have a genetic origin. In this case the thyroid gland is diffusely enlarged, soft, non-tender. All the tissues within are also enlarged. Although it may develop at any age and in either men or women, Graves' disease is more common in women and usually begins after age 20. The most common symptoms of GD are nervousness and anxiety, although not all patients complain of being nervous. In fact, in elderly patients, the primary symptoms are apathy and depression, leading to the term "apathetic hyperthyroidism." There's no way to stop your immune system from attacking the thyroid gland, but treatments can decrease the production of thyroxine.
Graves' disease is the most common form of hyperthyroidism. This over-activity is also sometimes called "toxic diffuse goiter." The thyroid gland helps set the rate of metabolism, which is the rate at which the body uses energy. Once the disorder has been correctly diagnosed, it is quite easy to treat. Graves - Basedow disease , also known simply as Graves' disease , is a medical disorder that may manifest several different conditions, including goitre and hyperthyroidism (over-activity of thyroid hormone production), infiltrative exophthalmos (protuberance of one or both eyes and associated problems) and infiltrative dermopathy (a skin condition usually of the lower extremities). When you have too much thyroid hormone in your system, your body's metabolism rate can increase by 60 percent to 100 percent because thyroxine regulates your cells' metabolism. The goal in treating GD is to reduce thyroid hormone levels in the blood. Graves' Disease also tends to affect women between the ages of 20 and 40, although it occurs in infants, children, and the elderly .This can be accomplished with both conventional and alternative medicine, although patients with moderate to severe hyperthyroidism may initially require conventional treatment until their symptoms are in control.
First described by Sir Robert Graves in the early 19th century, Graves' disease is one of the most common of all thyroid problems. When the thyroid is too active, it makes more thyroid hormones than the body needs. This abnormal immune response can also affect the tissue behind your eyes as well as your skin, usually on your lower legs and feet. This disorder is the most common cause of hyperthyroidism. It is known to be related to an antibody mediated type of auto-immunity, but the trigger for the reaction is unknown. In some cases, Graves' disease goes into remission or disappears completely after several months or years. Left untreated, however, it can lead to serious complications even death. The anti–sodium-iodide symporter, antithyroglobulin, and antithyroid peroxidase antibodies appear to have little role in the etiology of hyperthyroidism in Graves disease Graves' disease is rarely life-threatening.

Causes of Graves Disease

The common Causes of Graves Disease :

• The production of thyroid hormone is increased, causing a wide range of symptoms from anxiety and restlessness to insomnia and weight loss.
• Graves disease is caused by an abnormal immune system response that attacks the thyroid gland, and causes too much production of thyroid hormones.
• Eye muscles weakened by long periods of inflammation can lose their ability to control movement, resulting in double vision.
• Environmental factors associated with susceptibility are largely unproven other factors include infection, iodide intake, stress, steroids, and toxins. Smoking has been implicated in the worsening of Graves ophthalmopathy.
• In addition, the eyeballs may begin to stick out ( exophthalmos ), causing eye irritation and tearing.
• Chronic thyroiditis (Hashimoto thyroiditis) - Although the primary cause of hypothyroidism, the disease process occasionally presents initially with thyrotoxicosis

Symptoms of Graves Disease

Some common Symptoms of Graves Disease :

• Weight loss
• Abnormal breast enlargement (men)
• Increased appetite
• Muscle wasting
• Nervousness
• Restlessness
• Anxiety
• Light menstrual periods
• Increased eye tearing
• Difficulty sleeping
• Fatigue
• Infrequent or absent menstrual periods

Treatment of Graves Disease

Here is the list of the methods for treating Graves Disease :

• These medications, which include propranolol (Inderal), atenolol (Tenormin), metoprolol (Lopressor) and nadolol (Corgard), often relieve hyperthyroid signs and symptoms, such as a rapid heart rate, nervousness and tremors these medications aren't a cure for Graves' because your body will still produce too much thyroxine, but beta blockers block some of the action of the thyroid hormone.
• If you can't tolerate an anti-thyroid drug and don't want to have radioactive iodine therapy, surgery to remove your thyroid gland (thyroidectomy) is an option after the surgery, you'll likely need thyroxine treatment to supply your body with normal amounts of thyroid hormones.
• Sometimes use of prednisone (a steroid medication, which suppresses the immune system) is required to reduce eye irritation and swelling.
• Hyperthyroidism is treated with antithyroid medications, radioactive iodine, or surgery.
• Both radiation and surgery result in the need for lifelong use of replacement thyroid hormones, because these treatments destroy or remove the gland.
• Atrial fibrillation due to thyroid storm may be refractory to rate control, and conversion to sinus rhythm may be impossible until after antithyroid therapy has been initiated.
• Patients with severe thyrotoxicosis must be placed on a cardiac monitor the patient should be intubated if profoundly altered supplemental oxygen may be required. Aggressive fluid resuscitation may be indicated.

Cushings Disease

Cushing's syndrome or hypercortisolism or hyperadrenocorticism is an endocrine disorder caused by excessive levels of the endogenous corticosteroid hormone cortisol . Sometimes called "hypercortisolism," it is relatively rare and most commonly affects adults aged 20 to 50. An estimated 10 to 15 of every million people are affected each year. It was discovered by American physician, surgeon and endocrinologist Harvey Cushing (1869-1939) and reported by him in 1932. Cushing's syndrome occurs when the body's tissues are exposed to excessive levels of cortisol for long periods of time. Exposure to too much cortisol can occur from long-term use of synthetic glucocorticoid hormones to treat inflammatory illnesses. Another adrenal cortex hormone, aldosterone, regulates salt and water levels which affects blood volume and blood pressure. Hyperadrenocorticism occurs for two reasons a tumor of the adrenal gland that produces adrenal hormones or stimulation of the normal adrenal glands from the hormones that control it. The primary reason for this to occur is a pituitary gland tumor that produces excessive ACTH, which stimulates the adrenal gland to produce corticosteroids. Common symptoms of Cushing's syndrome include upper body obesity, severe fatigue and muscle weakness, high blood pressure, backache, elevated blood sugar, easy bruising, and bluish-red stretch marks on the skin. In women, there may be increased growth of facial and body hair, and menstrual periods may become irregular or stop completely.
Animal bodies are a marvel of interactions between organs and systems kept in balance by the production of enzymes that aid in metabolic processes and hormones that regulate body functions. When the balance is disturbed by illness, injury, or advancing age, the body goes awry: Cortisol affects the function of many organs in the body, so the signs of Cushing's disease may be varied. Hair loss caused by Cushing's disease occurs primarily on the body, sparing the head and legs. The skin is not usually itchy as it is with other skin diseases. People who have been diagnosed with depression, alcoholism, malnutrition and panic attacks tend to have higher cortisol levels as well. These types of Cushing's may be called Pseudo-Cushing's. With inflammation, the enzymes are excreted into the bloodstream and abdominal cavity instead of the gastrointestinal tract, resulting in a severe illness associated with vomiting, abdominal pain, peritonitis (inflammation of the abdominal cavity), and loss of protein into the abdominal cavity. When too much cortisol is produced in the adrenal glands, or an excess is taken in treating other diseases, significant changes occur in all of the tissues and organs of the body. All of these effects together are called Cushing's Syndrome.

Causes of Cushings Disease

The common Cause of Cushings Disease :

• A benign or malignant growth within the adrenal gland itself, which produces cortisol;
• Production within another part of the body (ectopic production) of a hormone that directly or indirectly stimulates the adrenal gland to make cortisol.
• Adrenal tumors
• An abnormal growth of the pituitary gland associated with an excessive production of one of its hormones, adrenocorticotropic hormone (ACTH), which stimulates the adrenal gland .
• Familial Cushing's syndrome.
• Symptoms of glucocorticoid excess generally occur with the administration of oral steroids; however, occasionally injections of steroids into joints and the use of steroid inhalers can cause Cushing syndrome.
• Patients who have undergone organ transplants also are at risk for developing Cushing syndrome due to exogenous steroids required as part of graft antirejection medication regimens.
• Long-term use of medication resembling cortisol (corticosteroids).

Symptoms of Cushings Disease

Some common Symptoms of Cushings Disease :

• Absence of menstruation (amenorrhea).
• You often get skin infections or other infections, and they take longer to heal. 
• High blood pressure ( hypertension ).
• Fatigue.
• Pink or purple stretch marks may form on your skin.
• Women usually have irregular menstrual periods and may grow thick or more visible body hair.
• Fever
• Sensation of abdominal "fullness".
• Seizures.
• Vomiting.

Treatmnent of Cushings Disease

• The best treatment for ectopic Cushing's syndrome is surgical removal of the tumor.
• The treatment for exogenous Cushing syndrome is gradual withdrawal of glucocorticoid.
• Gradual withdrawal of cortisone-type drugs (under close medical supervision)
• Bilateral adrenalectomy is an option if transsphenoidal surgery, pituitary irradiation, and medical therapy fail or if rapid normalization of cortisol levels is required. The patient then requires lifelong glucocorticoid and mineralocorticoid therapy.
• Patients receiving these medications may require glucocorticoid replacement to avoid adrenal insufficiency. Patients should be counseled on the signs and symptoms of adrenal insufficiency when starting these drugs.
• Drugs that inhibit cortisol synthesis - metyrapone, ketoconazole, aminoglutethimide. Indicated when case is not amenable to surgery.
• External beam irraidation of the pituitary - slow response and restricted when surgery unsuccessful, contraindicated or not acceptable to patient.

Megaloblastic Anemia

Pernicious anemia refers to a type of autoimmune anemia . In addition to the cells being large, the inner contents of each cell are not completely developed. The disease was named pernicious anemia because it was fatal before treatment became available, first as liver therapy and, subsequently, as purified vitamin B-12. The term pernicious is no longer appropriate, but it is retained for historical reasons. Diseases of the small intestine that cause malabsorption may cause vitamin B12 deficiency. Vegans (individuals who consume absolutely no foods of animal origin) are at risk of vitamin B12 deficiency due insufficiency of this vitamin in their diet. But it takes a long time to deplete all the vitamin B12 that is stored in the liver. There is a congenital form of pernicious anemia due to defect of intrinsic factor at birth that is clearly inherited as an autosomal recessive trait with the affected child having received two copies of the gene, one from each parent. Vitamin B12 helps in this shrinking process. Without vitamin B12, there are insufficient numbers of red blood cells, and those that are in the circulation are large and quickly become damaged. This leads to anemia, meaning that there is a deficiency of normal red blood cells. Symptoms, which usually begin gradually, include loss of appetite, diarrhea , paleness, fatigue, and headache. Tingling of the hands and feet, as well as the onset of spastic movements, may indicate that the nervous system has been affected. The word "pernicious" means highly injurious, destructive, or deadly. "Pernicious" comes from the Latin root "nex" meaning "violent death." Pernicious anemia was once quite deadly.
Megaloblastic anemia is a type of anemia characterized by very large red blood cells.xThe patient often has antibodies in the blood called intrinsic factor and parietal cell antibodies While the term pernicious anemia is reserved for patients with vitamin B-12 deficiency due to a lack of production of IF in the stomach, vitamin B-12 absorption is complex and other causes of vitamin B-12 deficiency exist and are described briefly in this article. They combine in the stomach and pass into the small intestine where the intrinsic factor helps the vitamin B12 get absorbed into the circulation. Doctors diagnose pernicious anemia when a patient with a low red blood cell count has large red blood cells and white blood cells with large, multi-lobed nuclei. Through the circulation, the vitamin is transported to the liver where it is stored, being released back into the circulation as needed. Without intrinsic factor, vitamin B12 is not absorbed and pernicious anemia occurs. Enlargement of liver and spleen (hepatosplenomegaly) may also occur, accompanied by yellow discoloration of the skin (jaundice) or pallor. Weakness, heart palpitations, difficulty breathing, as well as pain in the limbs are other possible symptoms. Mouth and tongue infection may also occur. Neurological lesions , irritability, and abnormal feelings (e.g. of heat and cold) may also be present. Megaloblastosis can also be caused by disorders in which cobalamin and folate uptake and metabolism are not affected. Myeloproliferative syndromes and viral infections (eg, HIV) can lead to megaloblastosis by disrupting DNA synthesis.
Causes of Megaloblastic Anemia
There are many factors which may cause Anemia, some common causes are listed below:

• Inadequate intake e.g. Elderly people
• Malabsorption in digestive system
• Chronic alcoholism
• Abdominal or intestinal surgery that affects intrinsic factor production or absorption
• Crohn's disease
  decreased production of intrinsic factor (this disease entity is called pernicious anemia)
• intestinal malabsorption (due to an enteritis, celiac disease or other causes)
  Intestinal malabsorption disorders
• Fish tape worm
• Disorders of terminal illness e.g cancers

Causes of Folic Acid Deficiency

• Atrophy or loss of gastric mucosa (eg, pernicious anemia, gastrectomy, ingestion of caustic material, hypochlorhydria, histamine 2 [H2] blockers).
• Inadequate proteolysis of dietary Cbl .
• Insufficient pancreatic protease (eg, chronic pancreatitis, Zollinger-Ellison syndrome).
• immune hemolytic anemia - drug-induced.
• Administration of folate will correct the anaemia but will not reverse any neurological disease - approximately 5% show no other symptoms but neurological disorder.
• Certain medications, specifically ones that prevent seizures, such as phenytoin, primidone, and phenobarbital, can impair the absorption of folic acid
• Folic acid is present in foods such as green vegetables, liver, and yeast.
• Dysfunctional uptake and use of cobalamin by cells (eg, defects in cellular deoxyadenosylcobalamin [AdoCbl] and methylcobalamin [MeCbl] synthesis).

Symptoms of Megaloblastic Anemia

The following are the most common symptoms of megaloblastic anemia. However, each child may experience symptoms differently. Symptoms may include:

• abnormal paleness or lack of color of the skin
• decreased appetite
• irritability
• lack of energy or tiring easily (fatigue)
• diarrhea
• difficulty walking
• numbness or tingling in hands and feet
• smooth and tender tongue
• weak muscles

The symptoms of megaloblastic anemia may resemble other blood conditions or medical problems. Always consult your child's physician for a diagnosis.

Treatment of Megaloblastic Anemia

Here is the list of the methods for treating Megaloblastic Anemia :

• To establish that the patient has Cbl deficiency
• Monitor the reticulocyte count (should return to normal in 2-3 weeks) and the Hb concentration (20-30g/L rise every week until normal)
• Intramuscular hydroxy-cobalamin daily for a week (regime will depend on the cause of the anaemia)
• You can treat vitamin B-12 deficiency related to a poor diet with changes in your diet along with vitamin B-12 supplementation, under a doctor's supervision.
• To confirm the diagnosis by documenting that specific therapy is effective
• your child's tolerance for specific medications, procedures, or therapies
• In some cases, blood transfusions and the medication erythropoeitin will correct anemia.
• To ensure administration of adequate quantities of Cbl for the lifespan of the patient
• your opinion or preference

Hemolytic Anemia

Hemolytic anemia is anemia due to hemolysis , the abnormal breakdown of red blood cells either in the blood vessels (intravascular hemolysis) or elsewhere in the body (extravascular). The mechanism by which the immune system mistakes the red blood cells for a "foreign invader" varies somewhat according to the cause. It usually involves adherence of the offending agent (parasite, drug or toxin) to the surface of the red blood cells.Autoimmune hemolytic anemia can also be caused by or occur with another disease, such as systemic lupus erythematosus, and rarely it follows the use of certain drugs, such as penicillin. Though much attention has been given recently to AIHA due to evidence linking the process of vaccinating with the manifestation of this sometimes life-threatening disease, immunization is only one potential cause for this condition. In particular, a form of damaged red blood cell known as a spherocyte occurs. Finding spherocytes on a blood smear almost guarantees that some form of hemolytic anemia is occurring Blood transfusions can be used in dogs with IMHA if necessary but they can make the condition worse so most vets reserve this approach for dogs that appear to be in imminent danger of dying due to severe anemia. It is necessary to treat most dogs for a fairly long time to prevent recurrence of the disease and some dogs seem to require lifelong use of corticosteroids or other immunosuppressants. Splenectomy is done in resistant cases since it is a major site of red blood cell destruction.
Idiopathic autoimmune hemolytic anemia results from an abnormality of the immune system that destroys red blood cells prematurely. It has numerous possible causes, ranging from relatively harmless to life-threatening. The immune system wishes to attack the offending agent, but manages to injure the red blood cells as well. When the spleen and the rest of the immune system is working to rid the body of the old, diseased or damaged red blood cells, it is doing its job properly. Whenever hemolytic anemia is present it is wise to carefully rule out initiating causes that might be treatable. Examples of problems that can lead to hemolytic anemia include ehrlichiosis (a blood parasite), reactions to sulfa antiseptics or penicillin antibiotics, zinc toxicosis - which can occur due to the ingestion of pennies. In some people, the destruction may stop after a period of time; whereas in other people, it persists and becomes chronic. There are two main types of autoimmune hemolytic anemia: warm antibody hemolytic anemia and cold antibody hemolytic anemia. In acquired hemolytic anemia, the person develops the condition from some other cause. Hemolytic anemia can begin rapidly or come on gradually and can range from mild to severe.

Causes of Hemolytic Anemia

The common Causes of Hemolytic Anemia :

• Autoimmune disorders, such as systemic lupus erythematous (SLE, or lupus), rheumatoid arthritis, Wiskott-Aldrich syndrome, or ulcerative colitis
• Drugs such as penicillin, antimalaria medications, sulfa medications or acetaminophen
• surgery, radiotherapy, chemotherapy and/or immunotherapy...
• Blood loss excessive bleeding such as hemorrhages or abnormal menstrual bleeding.
• Penicillin and its derivatives .
• Cephalosporins.
• Levodopa.
• Tumors.
• AIHA and hereditary spherocytosis are classified as examples of extravascular hemolysis because the RBCs are destroyed in the spleen and other reticuloendothelial organs.
• Hereditary spherocytosis.

Symptoms of Hemolytic Anemia

Some are common Symptoms of Hemolytic Anemia :

• Abnormal paleness or lack of color of the skin.
• Jaundice, or yellowing of the skin, eyes, and mouth.
• weakness.
• Dizziness.
• Pale color.
• Dark urine.
• Rapid heartbeat.
• Enlarged spleen.
• Confusion.
• Heart murmur.

Treatment of Hemolytic Anemia

• your age, overall health, and medical history
• vitamin and mineral supplements
• extent of the disease
• Surgical removal of the spleen generally is reserved for children who do not respond to other therapies.
• Administer packed RBC slowly to avoid cardiac stress.
• Corticosteroid medications, which are synthetic versions of natural hormones produced by the body's adrenal glands
• Blood transfusions are given with caution, if indicated for severe anemia , because of the potential that blood may not be compatible and may bring on a reaction.
• corticosteroid medications
• splenectomy - surgery to remove the spleen.
• Administer folic acid because active hemolysis may consume folate and cause megaloblastosis.

Hemochromatosis

What is hemochromatosis?

Hemochromatosis is the most common form of iron overload disease. Primary hemochromatosis, also called hereditary hemochromatosis, is an inherited disease. Secondary hemochromatosis is caused by anemia, alcoholism, and other disorders.
Juvenile hemochromatosis and neonatal hemochromatosis are two additional forms of the disease. Juvenile hemochromatosis leads to severe iron overload and liver and heart disease in adolescents and young adults between the ages of 15 and 30. The neonatal form causes rapid iron buildup in a baby’s liver that can lead to death.

Excess iron is stored in body tissues, specifically the liver, heart, and pancreas.
Hemochromatosis causes the body to absorb and store too much iron. The extra iron builds up in the body’s organs and damages them. Without treatment, the disease can cause the liver, heart, and pancreas to fail.
Iron is an essential nutrient found in many foods. The greatest amount is found in red meat and iron-fortified breads and cereals. In the body, iron becomes part of hemoglobin, a molecule in the blood that transports oxygen from the lungs to all body tissues.
Healthy people usually absorb about 10 percent of the iron contained in the food they eat, which meets normal dietary requirements. People with hemochromatosis absorb up to 30 percent of iron. Over time, they absorb and retain between five to 20 times more iron than the body needs.
Because the body has no natural way to rid itself of the excess iron, it is stored in body tissues, specifically the liver, heart, and pancreas.

What causes hemochromatosis?

Hereditary hemochromatosis is mainly caused by a defect in a gene called HFE, which helps regulate the amount of iron absorbed from food. The two known mutations of HFE are C282Y and H63D. C282Y is the most important. In people who inherit C282Y from both parents, the body absorbs too much iron and hemochromatosis can result. Those who inherit the defective gene from only one parent are carriers for the disease but usually do not develop it; however, they still may have higher than average iron absorption. Neither juvenile hemochromatosis nor neonatal hemochromatosis are caused by an HFE defect. Juvenile and neonatal hemochromatosis are caused by a mutation in a gene called hemojuvelin.

What are the risk factors of hemochromatosis?

Hereditary hemochromatosis is one of the most common genetic disorders in the United States. It most often affects Caucasians of Northern European descent, although other ethnic groups are also affected. About five people out of 1,000—0.5 percent—of the U.S. Caucasian population carry two copies of the hemochromatosis gene and are susceptible to developing the disease. One out of every 8 to 12 people is a carrier of one abnormal gene. Hemochromatosis is less common in African Americans, Asian Americans, Hispanics/Latinos, and American Indians.
Although both men and women can inherit the gene defect, men are more likely than women to be diagnosed with hereditary hemochromatosis at a younger age. On average, men develop symptoms and are diagnosed between 30 to 50 years of age. For women, the average age of diagnosis is about 50.

What are the symptoms of hemochromatosis?

Joint pain is the most common complaint of people with hemochromatosis. Other common symptoms include fatigue, lack of energy, abdominal pain, loss of sex drive, and heart problems. However, many people have no symptoms when they are diagnosed.
If the disease is not detected and treated early, iron may accumulate in body tissues and eventually lead to serious problems such as

• arthritis
• liver disease, including an enlarged liver, cirrhosis, cancer, and liver failure
• damage to the pancreas, possibly causing diabetes
• heart abnormalities, such as irregular heart rhythms or congestive heart failure
• impotence
• early menopause
• abnormal pigmentation of the skin, making it look gray or bronze
• thyroid deficiency
• damage to the adrenal glands

How is hemochromatosis diagnosed?

A thorough medical history, physical examination, and routine blood tests help rule out other conditions that could be causing the symptoms. This information often provides helpful clues, such as a family history of arthritis or unexplained liver disease.

• Blood tests can determine whether the amount of iron stored in the body is too high. The transferrin saturation test reveals how much iron is bound to the protein that carries iron in the blood. Transferrin saturation values higher than 45 percent are considered too high.
• The total iron binding capacity test measures how well your blood can transport iron, and the serum ferritin test shows the level of iron in the liver. If either of these tests shows higher than normal levels of iron in the body, doctors can order a special blood test to detect the HFE mutation, which will confirm the diagnosis. If the mutation is not present, hereditary hemochromatosis is not the reason for the iron buildup and the doctor will look for other causes.
• A liver biopsy may be needed, in which case a tiny piece of liver tissue is removed and examined with a microscope. The biopsy will show how much iron has accumulated in the liver and whether the liver is damaged.

Hemochromatosis is considered rare and doctors may not think to test for it. Thus, the disease is often not diagnosed or treated. The initial symptoms can be diverse, vague, and mimic the symptoms of many other diseases. The doctors also may focus on the conditions caused by hemochromatosis—arthritis, liver disease, heart disease, or diabetes—rather than on the underlying iron overload. However, if the iron overload caused by hemochromatosis is diagnosed and treated before organ damage has occurred, a person can live a normal, healthy life.
Hemochromatosis is usually treated by a specialist in liver disorders called a hepatologist, a specialist in digestive disorders called a gastroenterologist, or a specialist in blood disorders called a hematologist. Because of the other problems associated with hemochromatosis, other specialists may be involved in treatment, such as an endocrinologist, cardiologist, or rheumatologist. Internists or family practitioners can also treat the disease.

How is hemochromatosis treated?

Treatment is simple, inexpensive, and safe. The first step is to rid the body of excess iron. This process is called phlebotomy, which means removing blood the same way it is drawn from donors at blood banks. Based on the severity of the iron overload, a pint of blood will be taken once or twice a week for several months to a year, and occasionally longer. Blood ferritin levels will be tested periodically to monitor iron levels. The goal is to bring blood ferritin levels to the low end of normal and keep them there. Depending on the lab, that means 25 to 50 micrograms of ferritin per liter of serum.
Once iron levels return to normal, maintenance therapy begins, which involves giving a pint of blood every 2 to 4 months for life. Some people may need phlebotomies more often. An annual blood ferritin test will help determine how often blood should be removed. Regular follow-up with a specialist is also necessary.
If treatment begins before organs are damaged, associated conditions—such as liver disease, heart disease, arthritis, and diabetes—can be prevented. The outlook for people who already have these conditions at diagnosis depends on the degree of organ damage. For example, treating hemochromatosis can stop the progression of liver disease in its early stages, which leads to a normal life expectancy. However, if cirrhosis, or scarring of the liver, has developed, the person’s risk of developing liver cancer increases, even if iron stores are reduced to normal levels.
People with complications of hemochromatosis may want to receive treatment from a specialized hemochromatosis center. These centers are located throughout the country.
People with hemochromatosis should not take iron or vitamin C supplements. And those who have liver damage should not consume alcoholic beverages or raw seafood because they may further damage the liver.
Treatment cannot cure the conditions associated with established hemochromatosis, but it will help most of them improve. The main exception is arthritis, which does not improve even after excess iron is removed.

How is hemochromatosis tested?

Screening for hemochromatosis—testing people who have no symptoms—is not a routine part of medical care or checkups. However, researchers and public health officials do have some suggestions.

• Siblings of people who have hemochromatosis should have their blood tested to see if they have the disease or are carriers.
• Parents, children, and other close relatives of people who have the disease should consider being tested.
• Doctors should consider testing people who have joint disease, severe and continuing fatigue, heart disease, elevated liver enzymes, impotence, and diabetes because these conditions may result from hemochromatosis.

Since the genetic defect is common and early detection and treatment are so effective, some researchers and education and advocacy groups have suggested that widespread screening for hemochromatosis would be cost-effective and should be conducted. However, a simple, inexpensive, and accurate test for routine screening does not yet exist and the available options have limitations. For example, the genetic test provides a definitive diagnosis, but it is expensive. The blood test for transferrin saturation is widely available and relatively inexpensive, but it may have to be done twice with careful handling to confirm a diagnosis and show that the result is the consequence of iron overload.

Hope through Research

Scientists hope further study of the HFE gene will reveal how the body normally metabolizes iron. They also want to learn how iron injures cells and contributes to organ damage in other diseases, such as alcoholic liver disease, hepatitis C, porphyria cutanea tarda, heart disease, reproductive disorders, cancer, autoimmune hepatitis, diabetes, and joint disease.
Scientists are working to find out why only some patients with HFE mutations develop the disease. In addition, hemochromatosis research includes the following areas:
Genetics. Researchers are examining how the HFE gene normally regulates iron levels and why not everyone with an abnormal pair of genes develops the disease.
Pathogenesis. Scientists are studying how iron injures body cells. Iron is an essential nutrient, but above a certain level it can damage or even kill cells.
Epidemiology. Research is underway to explain why the amounts of iron people normally store in their bodies differ. Research is also being conducted to determine how many people with the defective HFE gene go on to develop symptoms and why some people develop symptoms and others do not.
Screening and testing. Scientists are working to determine at what age testing is most effective, which groups should be tested, and which are the best tests for widespread screening.

Mutant sperm guide clinicians to new diseases

Disease, DNA, deletions and duplications in human sperm

Human sperm:

Research published today in Nature Genetics shows that some rearrangements of the human genome occur more frequently than previously thought. The work is likely to lead to new identification of genes involved in disease and to improve diagnosis of genomic disease.
The scientists from the Wellcome Trust Sanger Institute looked at four unstable regions in the genome where rearrangements cause genetic diseases, so-called 'genomic disorders', and found that some of these rearrangements were found in sperm much more frequently than expected.
The team, led by Dr Matt Hurles, showed that losses or duplication of 'chunks' of the human genome occurred frequently in apparently healthy people. These losses or gains of DNA regions are called Copy Number Variants (CNVs), and can be found all over the genome in every individual.
Some of the mechanisms thought to produce CNVs would be expected to produce about one duplication for every deletion: however, clinical records for genomic disorders show only a few duplications, compared with hundreds of deletions.

" These are unfortunate accidents of the essential shuffling of our genetic deck of cards, a process essential to human life. "

Dr Matt Hurles

"There was no direct, global measure of the relative rate at which human DNA is gained or lost, a study that requires many thousands of human genomes," explained Dr Matt Hurles, Investigator at the Wellcome Trust Sanger Institute, "so we carried out a study on four clinically important regions using human sperm cells as our population of genomes. 
"Sperm cells give us an unbiased snapshot of CNVs: using our new highly-sensitive assays we can detect one rearrangement in a million cells."
The team looked at regions known to be affected by rearrangement in Williams-Beuren Syndrome, Charcot-Marie-Tooth disease Type 1A, Smith-Magenis Syndrome, and a deletion (AZFa) that causes male infertility. Their study showed that duplications are about half as frequent as deletions. By contrast, the two types of CNV are similarly common in healthy adults, suggesting that some deletions are too detrimental for the genome to tolerate.
"It is likely that deletions are more harmful than duplications, perhaps because a vital gene is removed, and so less likely to survive," explained Dr Hurles. "However, for some of the genomic regions we looked at, duplications can cause milder symptoms. Perhaps we can improve diagnosis with improved understanding of the possible consequences of duplications."
In Williams-Beuren Syndrome, loss of a genomic region (which can vary in size) can have very severe effects, including narrowing of arteries, facial and other skeletal deficiencies and impaired mental development. By contrast, duplications of the same regions have a milder effect, resulting most commonly in delay of speech development. With the results of this study, the team suggest that improved diagnosis might result from examining speech-delay for CNVs in this region.
"Although some of these CNVs arise much more frequently than anyone thought, they are still comfortingly rare: we see them in about 1 in 50,000 sperm cells," explained Dr Hurles. "These are unfortunate accidents of the essential shuffling of our genetic deck of cards, a process essential to human life. We need a new deal for each new person."
The method should also be able to detect rearrangements where none was suspected and to predict new disease-causing variants. Indeed one of the duplications that was detected in sperm has not yet been observed in the clinic, and yet it can be expected to cause disease, because smaller duplications of the same region cause Potocki-Lupski syndrome. Clinical genetics usually proceeds from observations in a patient down a long road to identify the gene involved. The new CNV work opens a new and possibly quicker, route of using new mutations found in sperm to lead to disease-causing mutations in patients.
In their work in 2006, the team has developed the CNV map for apparently healthy people: many of these are unlikely to cause disease. By looking across the entire genome for novel CNVs in human sperm, they will be able to predict where CNVs are likely to play a possible undiscovered role. In this 'reverse genetics', the new methods move from genome to prediction of consequences for patients.

Middle Aged People Ignore STI Risks

 Sexually transmitted infection (STI) or venereal disease (VD) is an illness that has a significant probability of transmission between humans or animals by means of sexual contact. Sexually Transmitted Diseases or VD, in recent years is known as sexually transmitted infection (STI) as it has a broader range of meaning. It could mean that a person may be infected, and may potentially infect others, without showing signs of disease.
 For long, there has been a misconception that STI are prevalent in young women and the older one gets, the lesser the chance of getting infected. This notion has lead to many middle aged people neglecting the possibility of getting infected and ignoring protection. According to a latest data, in the past decade sexually transmitted diseases have doubled in adults over the age of 45. The alarming part of this increase is that the spread of STI’s is rising at a faster rate in adults than in the young. A recent studied has re-enforced this and has shown proof that the middle aged adults had acquired an irresponsible attitude towards their sexual health. A poll was conducted wherein over 2000 adults between the ages of 45 and 54 were questioned about their sexual habits, especially protection related issues.
Based on the study, the results show that nearly a fifth of those adults who took part in the research have had unprotected sex with someone who is not their long-term partner in the past five years. The reasons for this relaxed attitude are that many adults believe that   acquiring an infection during middle age is very unlikely and also that the chance of women conceiving during middle age is very low. About quarter of those polled were of the opinion that they trusted their partners to not have an infection. Overall, the researchers found the older generation was flippant about the risks of acquiring an STI. This research throws light on the importance of educating the adults along with the young about the dangers of unprotected sex and its irreversible consequences.

Sexually Transmitted Diseases

Sexually transmitted diseases (also called STDs or STIs -- sexually transmitted infections) are infections that can be transferred from one person to another through sexual contact. According to the Centers for Disease Control there are over 15 million cases of sexually transmitted disease cases reported annually. Adolescents and young adults (15-24) are the age groups at the greatest risk for acquiring an STD, 3 million becoming infected each year.
It is important to recognize that sexual contact includes more than just intercourse. Sexual contact includes kissing, oral-genital contact, and the use of sexual "toys," such as vibrators. There really is no such thing as "safe" sex. The only truly safe sex is abstinence. Sex in the context of a monogamous relationship where neither party is infected with a STD is also considered "safe". Most people think that kissing is a safe activity. Unfortunately, syphilis, herpes, and other diseases can be contracted through this apparently harmless act. All other forms of sexual contact also carry some risk. Condoms are commonly thought to protect against STDs. Condoms are useful in helping to prevent certain diseases, such as HIV and gonorrhea. However, they are less effective protecting against herpes, trichomoniasis, and chlamydia. Condoms provide little protection against HPV, the cause of genital warts.
If you think you may have an STD or a related condition, see a doctor right away.

Why would I want to be tested for any sexually transmitted infections (STI)?
There are many different STIs. Some, like HIV, can cause serious illness and even death. Some, like Chlamydia and gonorrhoea, can cause infertility (not being able to get pregnant). The risk of developing serious health problems due to STIs can be reduced if the infection is diagnosed early, and best of all before there are any symptoms. If you have had unprotected sex (sex without using a condom), there is a risk that you could have an STI. Getting tested cuts your risk of ill health.

I have no symptoms. Does this mean I don't have a sexually transmitted infection (STI)?
No. Most people with an STI show no symptoms. If you have had sex without a condom, there is a risk that you could have an STI even if you have no symptoms and that means you could pass it on to future partners.

How is HIV passed on through sex?
HIV is present in blood, sexual fluids like vaginal fluids (in women) and in semen (in men). During sex, HIV can pass from the sexual fluids of one person to the bloodstream of the other, particularly where the lining of the skin or membrane is thin such as the vagina, urethra (tube that carries semen to the head of the penis) or anus (anal sex).

Can you get STIs from oral sex?
Yes. The commonest infection to be passed from the mouth is herpes - someone who has had cold sores can give genital herpes through oral sex. Infections such as gonorrhoea can be passed to the throat during oral sex. There is a very, very small risk that HIV could be passed through oral sex if somebody swallowed semen infected with HIV.
How can you tell if you have HIV?
The only absolutely accurate way is to have an HIV test done on a blood sample. Many people are infected with the virus and not know it themselves, as they show no symptoms. When symptoms do develop, they can be very similar to symptoms caused by other illnesses. A blood test therefore is the only way to detect the presence of HIV

Common STDs
A partial listing of sexually transmitted diseases:
 Chlamydia - Chlamydia is a very dangerous STD as it usually has no symptoms; 75% of infected women and 25% of infected men have no symptoms at all.
 Gonorrhea - Gonorrhea is one of the most frequently reported STD. 40% of it's victims contract PID if not treated, and it can cause sterility.
 Hepatitis B - A vaccine exists, but there's no cure; can cause cancer of the liver.
 Herpes - Painful and episodic; can be treated but there's no cure.
 HIV/AIDS - First recognized in 1984, AIDS is the sixth leading cause of death among young men and women. The virus is fatal involving a long, painful death.
 Human Papalloma Virus (HPV) & Genital Warts - The most common STD, 33% of all women have this virus, which can cause cervical or penile cancer and genital pain.
 Syphilis - Untreated, can lead to serious damage of the brain or heart.
 Trichomoniasis - Can cause foamy vaginal discharge or no symptoms at all. Can cause premature birth in pregnant women.

Chlamydia

Type of Infection: Bacterial; from the chlamydia trachomatis strain which lives in vaginal fluid and semen
Mode of Transmission: Mainly through vaginal and anal sex; although it is much less common, it can also be passed on via oral sex and hand to eye contact
Symptoms: Chlamydia is known as the "silent" disease since up to 75% of women and 50% of men infected with it display no symptoms. When there are any chlamydia signs and symptoms, it is most likely abnormal vaginal or penile discharge (mucus or pus) and painful urination. Symptoms of chlamydia in women can also include abdominal pain, low-grade fever, pain during intercourse and the need to urinate more often. Chlamydia in men can also make itself known through inflammation of the rectum and swelling or pain in the testicles.
Treatment: Antibiotics are used to cure the infection. To ensure proper treatment, make sure you finish all your medication and refrain from having sex until your have finished treatment and tests have shown the infection to be gone. It is important to be treated as soon as possible. While the infection can be cleared up, any damage it may have done prior to treatment cannot be undone.

Gonorrhea

Type of Infection: Bacterial; from the Neisseria gonorrheae bacteria
Mode of Transmission: Mainly through vaginal, anal and oral sex. Bacteria are transmitted through vaginal and seminal fluids. Infection can show up in the genital tract, mouth or rectum.
Symptoms: Once infected, symptoms of gonorrhea can take between two and ten days to show up. In women, the cervix is usually the first site of infection. From there, the infection moves up into the uterus and into the fallopian tubes. Women are much more likely than men to be asymptomatic. If they do develop symptoms, they are likely to include: bleeding after sex, pain or burning sensation when urinating, need to urinate more frequently, vaginal discharge that is yellow or bloody, cramps, bleeding between periods, nausea or vomiting and fever. In men, gonorrhea symptoms include a puss discharge from the penis (white, yellow or green in color) accompanied by pain, burning sensation when urinating and swollen testicles. If the infection is in the rectum, symptoms will include discharge, anal itching and painful bowel movements. It is also likely that your feces will have blood in them.
Treatment: Gonorrhea treatment usually consists of a single dose of medication. Depending on your age and whether or not you are pregnant, some antibiotics may not be suitable to take. Because it is very common for people to be infected with both gonorrhea and chlamydia at the same time, gonorrhea treatments often include medication for chlamydia as well. While the treatment can clear up the infection, it cannot undo any damage gonorrhea may have done to your reproductive system prior to treatment.

Genital Herpes (HSV-2)

There are two types of herpes virus: Herpes Simplex Virus 1 (HSV-1) and Herpes Simplex Virus 2 (HSV-2). Generally, HSV-1 is associated with oral herpes, marked by the presence of cold sores around the mouth, while HSV-2 is thought to be the cause of genital herpes. However, HSV-1 has also been shown to cause genital herpes. The herpes virus lives in certain nerve cells in your body where it remains for life.
Type of Infection: Viral
Mode of Transmission: Through direct skin-to-skin contact with the infected area during vaginal, anal or oral sex.
Symptoms: Although first episode symptoms of genital herpes tend to be worse than subsequent herpes outbreaks, often a person’s herpes symptoms are so mild they go unnoticed. If you have been exposed to the virus, genital herpes symptoms can take between two and ten days to appear. Symptoms of herpes can include an itching or burning sensation and pain around the infected area. Painful lesions in the vagina, on the penis, around the genital area or anus, and on the thighs or buttocks often occur as well. Female herpes symptoms may also include vaginal discharge. Women frequently develop vaginal herpes, with herpes bumps and sores occurring in the vagina.
Treatment: Currently, there is no herpes cure. However, you can receive herpes treatment to help relieve your discomfort during an outbreak as well as reduce the frequency of outbreaks. There are three different types of herpes medication available, one of which may help lower the risk of herpes transmission.

HIV/AIDS

Type of Infection: Viral
Mode of Transmission: Mainly through unprotected vaginal or anal sex as well as through breast milk and sharing drug needles with an infected person. May also be infected by performing oral sex on some who is infected or by sharing sex toys that have not been cleaned. While there was once concern about the possibility of infection through blood transfusions, strict screening procedures have been in place in North America and Europe for many years to prevent an infection from occurring this way. People living in other countries, though, may still be at risk of infection through blood transmission.
Symptoms: The initial symptoms of HIV are similar to the flu and include fever, swollen lymph glands, headaches, muscle aches, fatigue and fever. However, many people fail to notice any HIV symptoms. Although the virus can remain dormant in your system for many years, the virus will continue to weaken your immune system by attacking your CD4 cells. Once the viral load overwhelms your CD4 cells (or T4 cells), you will likely develop an opportunistic infection resulting in a diagnosis of AIDS (Acquired Immunodeficiency Syndrome).
Treatment: There is no cure for HIV or AIDS. HIV medications usually include antiviral drugs that are taken to hinder the growth and even kill off part of the HIV cells. Although this HIV/AIDS treatment does not work for everyone, they can help to keep you healthy and avoid the progression of the infection to AIDS.
Complications: The main complications associated with HIV are the increased risk of serious illness, developing AIDS, and dying of an AIDS-related complication.
Consequences in Infants: Approximately 25% of all babies born to women with HIV will also be infected and will develop HIV symptoms within their first year of life. However, the use of antiviral drugs during pregnancy can significantly reduce your risk of transmitting the virus to your baby.

Crabs

Pubic lice are parasitic insects that typically infest the hair surrounding the genital areas. They can attach to coarse body hair on the arms, legs, armpits, eyebrows, and eyelashes. Also referred to as "crabs" because of their pincers, these lice can cause itchiness and irritation in those infected. Genital crabs are one of the most common sexually transmitted infections with more than 3 million cases occurring in the United States every year. Genital crabs can be treated with prescription lotions or shampoos as well as over-the-counter remedies.
Type of Infection: Parasite
Modes of Transmission: Pubic crabs are easily transmitted between sexual partners. Any close contact with an infected person can result in you contracting the parasite. If your sexual partner is infested with pubic crabs, you have a 95% chance of becoming infected yourself. Pubic lice can also be transmitted within families as the lice can live for short periods of time on bedding, towels, and clothing. However, this type of transmission is unlikely, as crabs can only live for 48 hours without human blood. Genital crabs are common in cramped quarters and can run rampant in hostels, military bases, and anywhere where large numbers of people are in close contact with one another.
Symptoms: Crabs symptoms include itching and irritation in the genital area. Since crabs live off of your blood, you may find bluish spots where the crabs have been feeding. Dark spots may also be visible on your skin or underwear. These spots are the crab feces and indicate a definite infestation. Additionally, you may be able to see genital crabs crawling around in your pubic hair or find nits (eggs) close to the bottom of the pubic hair shaft. It is also common to experience a slight fever and feel irritated and run down when you have a pubic lice infestation.
Treatment: Genital crabs are easily treated through prescription or over-the-counter shampoos. In order to combat the infestation, follow the directions on the shampoo carefully. It is important to clean any clothes, bedding, and linens that have may have been infested. Any items that can’t be washed should be dry cleaned or stored in a plastic bag for a few days. This will kill any pubic crabs that may be present. To treat pubic crabs that have infested the eyebrows or eyelids, use a specially prescribed lotion that is safe for the eyes.

Hepatitis B (HBV)

Hepatitis B is a potentially serious disease that attacks your liver. It is a viral infection similar to Hepatitis A and Hepatitis C. Unlike Hepatitis A, however, the Hepatitis B virus (HBV) has the potential to seriously damage your liver and can cause chronic illness and even death. About 1.25 million Americans are currently infected with Hepatitis B. 10% of those infected will develop chronic Hepatitis B, in which the virus can stay in the body for years. 15 to 25% of those infected with chronic Hepatitis B will die from liver disease. A Hepatitis B vaccine is now available to safeguard against this virus.
Type of Infection: Viral
Mode of Transmission: Person to person exchange of bodily fluids: unprotected vaginal, oral, and anal sex; infected pregnant mom to unborn child; sharing of contaminated drug needles; piercing the skin with contaminated tattoo or piercing needles; piercing the skin with contaminated medical or dental instruments; receiving contaminated blood or blood products; and receiving contaminated tissues or organs.
Symptoms: A large percentage of those infected with Hepatitis are unaware that they are infected. About 30% of those with Hepatitis B experience no symptoms. Others feel like they have just caught a common flu. Hepatitis B symptoms can include: yellowing of the skin or the whites of the eyes (jaundice); fatigue or extreme fatigue; loss of appetite; nausea and vomiting; abdominal pain; fever and chills; dark, tea-colored urine; and grey or clay-colored bowel movements. It typically takes 9 to 21 weeks from the time of transmission for symptoms of Hepatitis B to manifest. Hepatitis B signs and symptoms are more likely to occur in infected adults than in infected children. 1% of those infected with HBV will experience extreme side effects. This is known as fulminant hepatitis. Fulminant hepatitis requires immediate medical attention.
Treatment: There is no known cure for Hepatitis B. Most infections will clear up within a few months. Those chronically-infected can be treated using the following drugs: Interferon Alfa or Lamivudine. These drugs will not cure Hepatitis B but they can markedly slow down its development as well as decrease the chance of liver disease.

Syphilis

Syphilis is a sexually transmitted disease caused by the bacteria Treponoma pallidum. It is often called the "Great Imitator" because syphilis symptoms resemble those of other common diseases. It has also been given the names "Miss. Siff" and "The Pox". Almost 36 000 cases of syphilis are reported in the United States each year but many more go unreported. The majority of syphilis sufferers are male, accounting for about 60% of all cases. If caught early on, syphilis can be easily treated. However, if left untreated, syphilis can cause heart problems, psychological disorders, blindness, and death. Syphilis also increases the risk of contracting HIV, the virus that causes AIDS, by up to five fold.
Type of Infection: Bacterial
Modes of Transmission: Syphilis is almost always transmitted through sexual contact with an infected person. The syphilis bacteria can easily spread from the ulcers on an infected person to the mucous linings of the mouth, genitals, and anus of an uninfected sexual partner. Though unlikely, it is possible to contract the infection by coming into contact with the broken skin of an infected person. Syphilis can also be passed from an infected mother to her unborn child.
Symptoms: Syphilis symptoms occur in stages. Primary syphilis results in painless sores called "chancres." These usually appear on the genitals, but they can also appear on the lips, tongue, and other body parts. These chancres generally disappear within a few weeks, but if left untreated, the disease can progress to chronic stages. Secondary syphilis begins with the syphilis rash. This is an infectious brown skin rash that typically occurs on the bottom of the feet and the palms of the hand. Fever, sore throat, swollen glands, and hair loss can also be experienced. The third stage of syphilis can last for many years, and you may suffer from joint and bone damage, increasing blindness, numbness in the extremities, or difficulty in coordinating movements.
Treatment: If caught early, syphilis is easily treatable. A single dose of an intramuscular penicillin injection can cure those infected within a year. 24 hours after this injection, you are no longer infectious. Some people don’t respond to these penicillin injections, or cannot receive them due to allergies. Other antibiotics are used in these cases. Frequent blood tests over a two year period are required to ensure that the syphilis bacteria has left your system. Treatment will not reverse any damage suffered as a result of the syphilis infection

HIV/Aids

What is HIV/Aids?

HIV is the cause of one of the most devastating epidemics ever to hit sub-Saharan Africa, but people with the infection can be encountered across the world. People who carry HIV may appear completely healthy.

However, the virus can be found in their blood and sexual fluids - and the most common way it spreads is when you have sex, either heterosexual or homosexual, with an infected person.

Although modern medication can keep an HIV-infected person from becoming ill with Aids for many years, there is currently no cure, and no vaccine, for the virus.

How can I protect myself?

Practising safe sex is vital to avoid the spread of Aids/HIV - male and female condoms are an important piece of luggage for the traveller intending to have sex at home or overseas.

Although condoms are available in most places in the world, experts advise travellers to stock up before they leave the UK.

Waiting to buy condoms in the travel resorts could result in problems if the condoms are of a poor standard or have been stored incorrectly in tropical conditions.

Where will I have the greatest risk?

In the 21 years since Aids - Acquired Immune Deficiency Syndrome - first appeared it has killed over 24 million people across the globe.

Another 40 million people are currently infected with HIV, but are not yet sick with Aids.

Sub-Saharan Africa is home to two-thirds of all HIV positive cases and South Africa has the largest number of people living with HIV and Aids in the world.

Parts of the Asia and the former Soviet Union are currently undergoing great Aids problems.

But travellers are just as likely to catch HIV through a sexual encounter in the UK.

How can I lessen my risk?

Obviously the most important ways of avoiding Aids are using a barrier method for sex; not sharing used needles and infected blood.

Choosing a sexual partner carefully and avoiding multiple partners can also lessen the risks.

But travellers should be aware that a casual pick-up in a nightclub is no less likely to be a carrier than a sex worker.

What do I do if I am raped?

Anyone who is raped abroad should ensure they get immediate specialist care. Forced sex particularly where the person is cut carries a greater risk of HIV transmission.

Antibiotics and anti-retroviral drugs should be started as soon as possible, particularly where there is a suspicion that the rapist might be an HIV carrier.

What if I get hurt on holiday?

A blood transfusion in a country which does not screen its blood is a high risk. But the risks do have to be weighed against the risk of death if a vital transfusion is delayed or avoided. Travellers can always take sterile medical kits abroad with them in case of emergencies.

Legionnaires’ disease

What is it?

Legionnaires' disease is a rare form of pneumonia, which is also called Legionellosis.

It was named after the first outbreak, which occurred in an American hotel, which was hosting a convention of the Pennsylvania Department of the American Legion.

It is generally contracted by inhaling mists from water sources like showers, whirlpool baths and cooling towers which have become infected with the bacteria.

The most common cause of the disease is contaminated air conditioning systems; it cannot be passed from one person to another.

What are the symptoms?

Legionnaires' has an incubation period of between two to 10 days.

The first symptoms are similar to flu - headaches, muscle pain and a general feeling of being unwell.

These progress to high fever, the chills, nausea, vomiting and diarrhoea.

On the second or third day the patient usually gets a dry cough and sometimes chest pains and they may have difficulty breathing.

Some patients also suffer from confusion; disorientation; hallucination and a loss of memory. Some also get pneumonia.

Will I die?

Legionnaires' disease does have a high fatality rate of about 5% to 15%. But if the disease is caught early enough the prognosis is better and patients are able to be treated with antibiotics.

Those with chronic diseases such as diabetes, cancer or serious kidney problems are extremely vulnerable if they catch the disease. Smokers and alcoholics are also more vulnerable.

How can I protect myself?

If you are concerned about making your hotel water supply as safe as possible, one way to do this is to run the taps in the bathroom for a few minutes with the bathroom door closed. When the steam has settled you can then use the bathroom taps. This gets rid of air bubbles in the pipes which may harbour the bug.

Hotels should regularly check the systems themselves, but sometimes rooms can be left unoccupied for some time.

Firms and buildings should also ensure that they carry out good engineering practices and regularly check the operation and maintenance of air and water handling systems.

Abscesses

An abscess is formed when pus accumulates in a tissue, organ, confined space in the body due to an infection. An abscess can form in the brain, lungs, teeth, gums, under arms, GI tract, abdominal wall, ears, tonsils, sinuses, bones, breasts, kidneys, prostate gland, rectum, scrotum, and to almost any part of the body. They may indeed be located externally or internally and may result from injury or a lowered resistance to infection.

The affected area may be swollen, inflamed, hot, red, and tender. The individual may also experience fatigue, weight; loss, anorexia, and alternating bouts of fever and chills. Rupture of the abscess and in severe cases, bacteremia (blood infection) can occur. The material inside an abscess consists of living and dead white blood cells, bacteria, dead tissue, and toxins – all of which can be discarded from the body.

An abscess is said to be acute if it appears suddenly ( in a matter of a few hours or overnight) and is termed chronic is it has been present for a period of days or weeks. Acute abscesses generally respond better to treatment in a matter of days.

Basically, an abscess is a sign that the body is trying to rid itself of impurities. The impurities may be half-starved cells, deficient in nutrients such as sulfur, or toxins that accumulate because of a failure of the normal eliminative processes. Such a situation stems from poor diet and exposure to environmental pollutants, chemicals, or harmful substances. Eating junk food not only clutters the system with food lacking in nutrients, but also prevents the cellular wastes from being eliminated efficiently by causing problems such as constipation and a sluggish liver, spleen, and kidney function.

Family Planning

Family planning is a very personal issue among couples. There are several family planning choices offered today. Some of these choices, however, are costly and have many harmful side effects to both men and women, many of which are not disscussed with patients. In order to make an informed family planning decision, we feel that you must be aware of how artificial birth control methods work, and the risks you take when using them.

To understand why the birth control pill, the Depo-Provera injections, The Patch and Norplant deserve to be classified as abortifacients, we must review carefully their mechanism of action inter uterine devices, etc. The most commonly used, the Pill, typically contains a combination of the hormones estrogen and progesterone.

The Pill’s three distinct effects on the female reproductive system:

• Suppresses ovulation
• Thickens the cervical mucus to impede sperm penetration
• Alters the inner lining (endometrium) of the uterus, the nutrient-rich lining to which the baby is attached for the majority of the pregnancy.12
  

THE PILL

FACTS Two Kinds: "combined Pill," which contains two female hormones, estrogen and progestin, and is taken 21 days out of each month. "Mini-Pill," which contains progestin only and is taken continuously. Typical first-year failure rate is 3 percent; 4.7 percent for women less than 22 years old2 (Failure rate even higher for imperfect use; i.e. user forgets or "skips" a pill now and then) No protection against HIV/AIDS

MODE OF ACTION Through chemical signals to the brain, suppresses ovulation (essential action of estrogens) Thickens cervical mucus, making it impenetrable to sperm (essential action of progestins) Alters endometrium so uterus is not receptive to implantation of fertilized egg (newly conceived human life); therefore, sometimes acts as abortifacient

POTENTIAL SIDE EFFECTS In addition to possible nausea, vomiting, headache, and weight gain or loss. Increased blood pressure (hypertension) Impaired vision, Increased risk of stroke or heart attack, even with new "low" dose pill Confirmed link to breast cancer of reproductive organs Confirm link to heart decease Increased risk of gall bladder disease Increased danger of developing liver tumors Difficulty in conceiving after discontinuing use of pill Residual risk of heart attack, even after discontinuation of long-term use Reduced blood levels of essential vitamins Development of depressive personality changes

WORLD HEALTH ORGANIZATION ADMISSION

The recent press release of July 29, 2005 by the International Agency for Research on Cancer (IARC) a division of the world health organization (WHO), revealed the little publicized classification of combined estrogen-progestogen oral contraceptives (OCs) as carcinogenic. The IARC placed the contraceptive/abortifacients into its group 1 classification, which is the highest classification of carcinogenicity. This classification is only used “When there is sufficient evidence of carcinogenicity in humans”

Combined estrogen-progestogen OCs are the most commonly prescribed methods of artificial birth control. “Worldwide, more than 100 million women – about 10% of all women of reproductive age – currently use combined hormonal contraceptives”. Tragically, the WHO is only admitting “late” what was already reported in 2003 by the National Cancer Institute (NCI) and other scientific bodies that have found a substantially increased risk of several types of cancer among combined OC users, citing a “significant increase” of the risk of breast cancer, as well as an increase in the risk of cervical and liver cancers. What they failed to report is that millions of women are being given the same carcinogenic chemicals, particularly the poor in Third World countries, through the Depo- Provera injections, implants, patches, Intra-uterine devices, etc. Even though there is immediate danger to the millions of women, who are regularly ingesting or inserting “Carcinogenic chemicals”, the IARC did not recommend the immediate removal of combined estrogen-progestogen oral contraceptives from the market.

Your return to normal cycles will depend on how long you have been using artificial methods of birth control. Following is a possible example of how the body tries to return to fertility after using the birth control pill for less than one year.

To better understand your cycles of fertility and infertility, please download our book and/or our charting coach, and call us in order to give you the name of a teacher near you area to assist you in the follow up of your cycles. Eventually, your cycles will return to normal like the example below.

Good nutrition and vitamins seem to help the return to fertility and average cycles.

UNDERSTAND YOUR FERTILE & INFERTILE DAYS OF THE OVULATION METHOD

To POSTPONE Pregnancy Use the Infertile Days

The Ovulation Method is not the old "rhythm method" or the temperature method. It is a new scientifically proven method, researched by Dr. John Billings with the scientific research confirmed by the famous endocrinologist James B. Brown. This method is based on the simple recognition of natural signs of fertility that appear for a few days during the woman\'s menstrual cycle. Family of the Americas (FAF) was instrumental in simplifying the teaching and charting system of the Ovulation Method that made it applicable for universal use.

By keeping accurate records, a woman can now confidently identify the fertile and infertile phases of her cycle. Women with long or irregular cycles, breast-feeding mothers, and even those going through pre-menopause or discontinuing artificial methods of family planning may use the Ovulation Method safely and effectively.

CONDOMS

1. Facts
   1. Thin rubber or latex sheath worn over the erect penis during intercourse
   2. Condoms are not in cool, dry place the rubber deteriorate; likewise, condoms have limited “shelf life” as condom materials deteriorate over time
   3. Use of lubricants and/or spermicides can cause condom failure by accelerating deterioration of condom rubber
      
2. Potential Side Effects
   1. Effective only 84 to 88 percent of the time, at best. (Chance of pregnancy over one-year use is one in six.)
   2. Unmarried minority women the failure rate of condoms is even higher, some 36 percent; among unmarried Hispanic women the failure rate is as high as 44.5 percent
   3. Contrary to claims that condoms can be an effective means of preventing veneral diseases the spread of HIV, the fact is that the human immunodeficiency virus is 500 times smaller than a human sperm. Obviously, since condoms fail anywhere from 12 to 44 percent of the time in preventing pregnancy, they are even less
   4. Effective in preventing the transmission of this tiny virus.

HIV/AIDS

Acquired immunodeficiency syndrome (AIDS) is a fatal disease that shows no symptoms for long periods and is usually spread or contracted unknowingly. Contrary to claims that condom use during intercourse is “safe sex,” even their most glowing advocates must admit that these devices work, at best, only 88 percent of the time – that users have more than a ten percent chance of catching a 100 percent fatal disease. Other studies indicate a mere 70 percent success rate for condoms – a nearly one in three risk of contracting HIV.

There exists direct evidence of voids in condom rubber. Electron micrographs reveal voids of 5 microns in size (50 times larger than the virus) while fracture mechanics analyses, sensitive to the largest flaws present, suggest inherent flaws as large as the [sic] 50 microns (500 times the size of the virus).”

Over the course of a year, the average woman whose partner uses condoms has a one in six chance of becoming pregnant. The chance of contracting AIDS is even higher since HIV is 500 times smaller than a human sperm and 1/10th to 1/3rd the size of the smallest detectable hole in a condom. Moreover, while a woman can become pregnant only 100 hours each month, due to the nature of her ovulatory cycle, HIV can be transmitted at any time.

Whether among heterosexuals or homosexuals, AIDS is clearly linked to promiscuous and/or unnatural sexual activity, such as sodomy (anal intercourse), as well as intravenous drug use.

SPERMICIDES

• Facts
  1. Available in many forms, including creams, jellies, suppositories, aerosol foam and foam tablets
  2. Only 74.8 percent effective
• Mode of Action
  1. Form chemical barrier at opening to uterus that prevents sperm from reaching egg in uterus; may also destroy or damage sperm
• Potential Side Effects
  1. Greater incidence of these congenital disorders in innocent children who are conceived during use of spermicides: Down\'s Syndrome, limb reduction malformations, malignant neoplasms (cancerous tissue growths) and severe hypospadias
  2. Increased chance of vaginal infections because absorption of spermicide alters vagina\'s normal chemical environment
  3. Possible link to increased risk of HIV
     

DIAPHRAGM

• Facts
  1. Flexible metal ring covered with rubber in shape of shallow dome
  2. Only 84. 1 percent effective
  3. Risk of failure is approximately doubled when the user is less than 30 years old or has intercourse 4 times or more weekly
• Mode of Action
  1. Placed in vagina to completely encircle the cervix and to prevent sperm from entering the uterus
  2. Usually used with spermicidal jelly or cream applied to side of dome facing cervix
• Potential side effects
  1. New England Journal of Medicine reports evidence of link between diaphragm use and toxic shock syndrome
  2. Local skin irritation caused by sensitivity or allergy

  
  

STERILIZATION (Female)

• Facts
  1. More or less irreversible technique for preventing conception
  2. Two kinds:
     a. Tubal Ligation or electrocoagulation, which seals off Fallopian tubes and prevents passage of eggs between ovaries and uterus (overall failure rate of .15 percent)
     b. hysterectomy, which removes uterus
• Potential Side Effects
  1. Severe bleeding
  2. Pelvic infection
  3. Ectopic pregnancy (risk as much as three times higher)
  4. Subsequent hysterectomy because of severe menstrual problems
  5. Death due to anesthesia, perforation of aorta, and bowel burns
  6. Post-operative depression
  7. Sexual dysfunction
  8. Risk of later desire for sterilization reversal
  9. Women who have had tubal ligations report more cramping than they were accustomed to previously, and chances of pregnancy after tubal ligation are two to five percent

STERILIZATION (Male)

• Facts
  1. Called vasectomy – virtually irreversible operation that removes a piece of both the left and the right vas deferens (tubes through which sperm travel from the testes to the prostate) and ties off ends
  2. May not be effective for up to three months because of residual sperm cells
  3. Failure rate of .15 percent; recannulation (re-establishment of vas deferens by internal healing process) occurs in 1 case per 1,000
• Potential Side Effects

  1. Sperm production is same as before, about 50,000 spermatozoa every minute. However, sperm are not ejaculated so they enter the bloodstream where antibodies are produced to remove the sperm from the bodily system. This can lead to thyroid and joint disorders, heart and circulatory diseases, and diabetes. When the body activates defenses to ward off cells of its own making, as after a vasectomy, the body becomes “auto-immune” (allergic to itself). Several studies have found such antibodies generated in response to sperm antigens in 55 to 75 percent of patients within two years after their vasectomies.
  2. Two studies in the United States have found that men with vasectomies have an 85-90 percent higher risk of being diagnosed later with prostate cancer than men who elect not to have the surgery.
  3. Psychological difficulties, including anxiety and feelings of low self-worth, decreased sexual desire. A standard personality disorder test found that over 40 percent of one vasectomy study group experienced personality disturbances between their first testing and testing a year later, after the operation.
  4. Increased risk of kidney problems, including kidney stones.

The only surgery that is done deliberately to destroy the natural functioning of sound, healthy organs, sterilization-for-birth control is an extreme act of self-mutilation that often has a profound negative effect on the personal relationship between husband and wife. “Having made their love lifeless,” as one observer puts it, “sterilized couples deprive each other of the miraculous gift of combined fertility, a truly wonderful gift that would otherwise enable them to be cooperators with God in the conception of new life.” That\'s certainly one way to take the “magic” out of one\'s marriage.

ABORTION

INDUCED ABORTION

It is fitting that our discussion of artificial methods of birth control lead to a discussion of abortion, because the contraceptive mentality (saying "No" to the potential for new life) and abortion (eliminating new life) are clearly entwined.

1. Facts
   1. All forms of induced abortion involve the premeditated killing of the unborn baby in the mother\'s womb
   2. More than 1.5 million annually in the United States alone
   3. Estimated 46 million abortions around the world annually as reported by the World Health Organization, "Reproductive Health, A Key to a brighter Future," June 1992.
   4. However, most artificial methods of birth control act as abortifacients, (the Pill, The Patch, the Intra-uterine Device, the Norplant, etc). Therefore, more abortions are taking place chemically and mechanically than surgically. Since abortions are linked to cancer and heart disease, as recently reported by the World Health Organization in July 2005, it coincides with the high incidence of such deadly diseases on women worldwide.

Introduction to the National Cancer Institute Funded Study of Risk of Breast Cancer in Women under Age 45 Who Had Induced Abortion (s) The breast is the site of the most frequent malignancy in the human female population. Breast cancer is the second in mortality (cancer deaths in women). A woman’s risk of breast cancer is influenced by her reproductive history. Reserchers at the Fred Hutchinson Cancer Center in Seattle found that women who had been pregnant at least once and who had an abortion face a 50% greater risk of developing breast cancer than those who had never had an abortion. The risk was highest among those who had never had an abortion. The risk was highest among those who had abortions before age 18 or after age 30. Within these two groups, the risk of breast cancer increases if the abortion occurs between the eighth and twelfth weeks of pregnancy. The theory that this study supports is that the link between breast cancer risk and induced abortion is due to differentiation in breast lobular structures. The mammary gland seems to be the only organ that is not fully developed at birth. It changes dramatically in size, shape and function in response to growth, puberty, preganancy and laction. It is known that women with a history of early, full-term pregnancy are at lower risk for developing breast cancer than those who have never had a child. Differentiation of breast structures has been credited with this protective effect since carcinomas originate in undifferentiated cells (Lobule type 1 and, on occasion, type 2). When pregnancy is terminated by abortion, cell differentiation does not occur, thus increasing the number of cells susceptible to cancer-causing agents. When abortion takes place prior to the second trimester, cells have not yet progressed to Lobule 3 stage. Undifferentiated Lobule types 1 and 2 predominate, increasing the possibility of tumors. Source: Jornal of the National Cancer Institute, 86, no. 21 (November 2 1994). The Houston Cronicle, Octuber 26, 1994, p.10 A, by Tom Paulson, Seatle Post-Intelligence © 1996 Family of the Americas

Risk of Breast Cancer among Young Women: Relationship to Induced Abortion According to a National Cancer Instutute Study of 1,800 women over a seven-year period. Percentage of increase of breast cancer Source: Journal of the National Cancer Institute, 86, no. 21 (November 2, 1994). The Houston Chronicle, October 26, 1994, p. 10A, by Tom Paulson, Seattle Post - Intelligence

Abortion Methods and Their Complications

1. 1. Early Abortion
      
      SUCTION or DILATION AND CURETTAGE (D&C)
      
      Most abortions are done using these methods at around eleven to twelve weeks gestation. It is important to note that, as early as nine weeks, the unborn baby responds to touch and can feel pain. The fetal heart is beating, and eyes, fingers and toes are distinguishable. In a suction abortion, the abortionist inserts a long hollow tube through the cervix and then, with powerful vacuum force, tears the placenta away from the uterine wall, dismembering the baby (fetus) and drawing his remains into an attached jar. In a D&C, the abortionist inserts a loop-shaped knife into the mother\'s dilated cervix and by scraping the uterine wall, dismembers the baby (fetus). To ensure that the procedure is complete and no body parts remain in the womb (where they may cause infection), the abortionist or nurse must "reassemble" the fetal body to ensure that head, torso, and limbs are present. (A similar procedure, dilation and evacuation [D&E], "extends both the traditional D and C and the vacuum curettage into the second trimester. D and E is especially appropriate for procedures done in the range of 13 – 16 weeks gestation, although many proponents use this method up through 20+ weeks.")41 Hatcher et al., Contraceptive Technology, p. 45i.
      
      Complications include:
      
      
      • laceration of cervix by suction apparatus or knife
      • hemorrhage
      • perforated uterus
      • laceration of urinary bladder and ureters
      • pulmonary embolism (air bubble in bloodstream)
      • laceration of bowel and subsequent infection
      • shock
      • reactions to anesthesia, including bronchial obstruction, anaphylactic shock, and cardiac arrest
      • reaction to blood transfusion
      • laparotomy (surgical section of abdominal wall)
      • hysterectomy
      • retained tissue
      • death of mother
      • much higher risk of developing breast cancer. Women who abort their first pregnancy almost double their chance of developing breast cancer. The Deadly After-Effect of Abortion-Breast Cancer, pamphlet published by Hayes Publishing Co., Cincinnati, Ohio.
        
        
   2. Late Abortion
      
      SALINE
      
      After sixteen weeks, the baby (fetus) is too large to be killed by the procedures mentioned above, so abortionists resort to saline injection (salt poisoning). It is important to note that, since eleven weeks gestation, all of the baby\'s organs have been complete and functioning. At sixteen weeks, medical photographers and ultrasonographers have pictured unborn babies kicking and swimming — even sucking their thumbs. According to the U.S. Centers for Disease Control and Prevention, more than 77,000 American babies are aborted each year at this age or older.
      
      In a saline abortion, the abortionist inserts a long needle through the mother\'s abdomen, siphons off some of the amniotic fluid that protects the baby and replaces that amount with a saline (salt) solution that both poisons the baby as he swallows and burns away his skin. The mother goes into labor and delivers a dead infant.
      
      Complications include:
      
      
      • transplacental hemorrhage
      • reactions to anesthesia
      • hypernatremia
      • edema (swelling) of brain
      • convulsions
      • coma
      • kidney failure
      • heart failure
      • failure to abort after death of baby
      • baby born alive and badly burned

      Similar to saline abortions are those by the injection of prostaglandins (powerful hormones that induce violent labor and premature birth). Abortionists may inject toxin to kill the baby first. "Clinicians are performing an increasing percentage of second trimester instillation abortions by combinations of the just described methods." 45 Hatcher et al., Contraceptive Technology, p. 453.

   3. Late Abortion
      
      HYSTEROTOMY
      
      Similar to a cesarean section, this late-term form of abortion involves removal of the baby from the uterus. The child is killed or left to die.
      
      Complications include:

      • hemorrhage
      • reaction to blood transfusion
      • reaction to anesthesia
      • hysterectomy
      • high mortality rate for mothers
        
        
   4. RU-486
      
      Also known as the "abortion pill," RU-486 actually involves a cumbersome and expensive four-step regimen that includes the taking of several powerful drugs and at least four visits to the abortionist. Janice Raymond, self-proclaimed "feminist" and associate director of the Institute on Women and Technology at MIT, says, "Claims that RU 486 abortion is private and demedicalized are belied by the number of medical visits and the whole drug cocktail a woman may be exposed to. "Susan Ince, "The Trouble with RU486," Vogue, July 1991, p. 88. By preventing the action of progesterone in the womb, RU-486 works as an abortifacient for the first eight to ten weeks after conception. RU-486 is used with prostaglandins (misoprostol) to increase lethality.
      
      Complications include:
      
      
      • nausea
      • vomiting
      • diarrhea
      • severe and sometimes prolonged bleeding (in some women, even two months after discontinuance) In a recent clinical study in Britain, five hundred eighty-eight women were given abortions with RU-48 combined with the prostaglandin gemeprost. Five of the women bled so much that they required transfusions. One hundred sixty-six of them needed narcotics to ease the pain... Thirty five failed to abort and had to undergo a follow-up surgical procedure. And together they averaged more than twenty days of heavy bleeding afterwards." George Grant, The Quick and the Dead:RU-486 and the New Chemical Warfare against Your Family (Wheaton, Ill.: Good News Publishers, 1991), p. 50. Cities August 1991 issue of the American Druggist.
      • failure to expel baby (this happens in one out of every twenty cases, Grant, Quick and the Dead, p. 53. so another method of abortion is sought)
      • cardiovascular shock
      • maternal death Ibid., p. 51 When the first maternal deaths were reported in 1991, the French Ministry of Health devised stringent new regulations for the use of RU-486.
        
        
   5. PROSTAGLANDIN-INDUCED ABORTION
      
      As mentioned under entry for saline abortion and RU-486, prostaglandins are powerful hormones that induce violent contractions of the womb and expulsion of the baby.
      
      Complications include:
      
      
      • retained fetal tissue
      • readmission for surgery
      • septicemia (massive infection)
      • pelvic inflammatory disease
      • peritonitis
      • blood dyscrasias — afibrinogenanemia (failure of blood to clot)
      • bleeding
      • lung abscess (aspiration of vomitus during anesthesia)
      • deep vein thrombosis
      • death of mother
      • Post-Abortion Syndrome
        
        
   6. DILATION AND EXTRACTION (D&X)
      
      Developed by an abortionist who notes that "most surgeons find [fetal] dismemberment at 20 weeks and beyond to be difficult due to the toughness of fetal tissues at this stage," D&X requires the mother\'s cervix to be dilated and the placenta (bag of waters) to be broken. The abortionist\'s assistant then uses ultrasound to scan the mother\'s abdomen and to locate the lower extremities of the unborn baby. Using forceps, the abortionist pulls the baby, by its legs, down into the vagina. The abortionist uses his hands to pull the fetal arms and shoulders from the womb and to turn the baby on his or her stomach. The baby\'s head, which is too large to pass through, remains lodged at the cervix. Holding sharp, curved scissors, the abortionist follows the curve of the fetal spine to find the base of the skull. "He then forces the scissors into the base of the skull. Having entered the skull he then spreads the scissors to enlarge the opening. He then removes the scissors and introduces a suction catheter into the hole and evacuates the skull contents." Once the skull is empty, it is more readily crushed, enabling the baby\'s body to be removed entirely from his or her mother. This is the D&X procedure as described by Ohio abortionist Martin Haskell, who claims to have performed more than seven hundred such procedures in his two offices.50 Dr. Martin Haskell, paper presented at the National Abortion Federation Risk Management Seminar, Dallas Texas, September 13, 1992. Several states, including Ohio, and at least one U.S. Congressional Representative have drafted legislation that, if enacted and enforced, would prohibit these partial-birth killings. Some two hundred of these procedures are done each year in the state of Ohio alone.
      
      In September, 1993 Brenda Pratt Shafer, a registered nurse with thirteen years of experience, was assigned by her nursing agency to an abortion clinic. Since Nurse Shafer considered herself "very pro-choice, " she didn\'t think this assignment would be a problem. She was wrong.
      
      This is what Nurse Shafer saw:
      
      I stood at the doctor\'s side and watched him perform a partial-birth abortion on a woman who was six months pregnant. The baby\'s heartbeat was clearly visible on the ultrasound screen. The doctor delivered the baby\'s body and arms, everything but his little head. The baby\'s body was moving. His little fingers were clasping together. He was kicking his feet. The doctor took a pair of scissors and inserted them into the back of the baby\'s head, and the baby\'s arms jerked out in a flinch, a startle reaction, like a baby does when he thinks that he might fall. Then the doctor opened the scissors up. Then he stuck the high-powered suction tube into the hole and sucked the baby\'s brains out. Now the baby was completely limp.
      
      I never went back to the clinic. But I am still haunted by the face of that little boy. It was the most perfect, angelic face I have ever seen.
      
      The "Partial Birth Abortion" Bill, which would have made this technique illegal, was vetoed by President Clinton on April 10, 1996.
      
      
2. Effects of Abortion on Subsequent Childbearing

• potential sterility
• 50 percent increase in spontaneous miscarriage
• 200 percent increase in ectopic pregnancy
  
  All forms of abortion may include a reaction to or admission of participation in death of one\'s own infant. This may manifest itself as severe and prolonged depression, mourning, sense of loss (sometimes delayed for years), plus:
  
  
• 40 percent increase in mental retardation among children
• prolonged labor
• rupture of uterine scar (post-hysterectomy)
• development of Rh antibodies in Rh-negative mother
• cervical incompetence (after early abortions) resulting in miscarriages