Tag: Nausea and Vomiting

Addison’s Disease

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What is Addison’s disease?
Addison’s disease is a condition that affects your body’s adrenal glands. These glands are located on top of your kidneys. They make hormones that affect your mood, growth, metabolism, tissue function, and how your body responds to stress.

Addison’s disease damages those glands. It causes your body to shut down production of the hormones. The disease commonly affects people 30 to 50 years of age. However, it can occur at any age and affects both men and women.

Symptoms of Addison’s disease
Symptoms appear over a period of several months. They are difficult to diagnose because they are vague. Symptoms include:

fatigue
muscle weakness
joint or muscle pain
fever
weight loss
nausea, vomiting, and or diarrhea (leading to dehydration)
headache
sweating
changes in mood or personality, such as irritability, anxiety, or depression
loss of appetite
darkening of the skin (called hyperpigmentation)
lightheadedness or fainting when standing up, due to low blood pressure
cravings for salty food
sudden, severe pain in the abdomen (lower stomach), lower back, or legs
confusion or slurred speech
sluggish movements
seizures
high fever.
When symptoms appear suddenly, or quickly get worse, it is called acute adrenal failure. Sometimes it’s called Addisonian crisis. This can lead to death if not treated. If you have any of the following symptoms, contact your doctor or go to an emergency room immediately.

sudden, intense pain in your lower back, abdomen, or legs
severe vomiting and diarrhea (which will lead to dehydration)
lower than normal blood pressure
unconsciousness
high levels of potassium and low levels of sodium.
What causes Addison’s disease?
Addison’s disease is caused by injury to your adrenal glands or when your glands are affected by another medical condition. This is called adrenal insufficiency. There are 2 types of adrenal insufficiency:

Primary adrenal insufficiency: This occurs through damage to your adrenal glands by an autoimmune disease (when your body attacks its own immune system). Other causes of primary adrenal insufficiency include:

Tuberculosis (or other infections) of the adrenal glands
Cancer of the adrenal glands
Bleeding of the adrenal glands
Secondary adrenal insufficiency: This occurs when another condition causes the adrenal glands to stop producing hormones. For example, a problem with your pituitary gland can cause secondary Addison’s disease. Or, you may develop Addison’s disease if you suddenly stop taking a corticosteroid medicine (such as prednisone). Corticosteroids are sometimes prescribed to treat conditions such as asthma, allergies, arthritis, cancer, and immune system problems.

How is Addison’s disease diagnosed?
Your doctor will ask you about your medical history and your symptoms. He or she may also perform laboratory tests to determine whether you have Addison’s disease. Those lab tests include:

Blood tests to measure your body’s hormone and mineral levels. Your doctor may check your blood before and after an injection to see if your body is responding normally to increased levels of certain hormones.
Computerized tomography (CT) scan or magnetic resonance imaging (MRI) to look at the size of your adrenal glands or pituitary gland. These scans are similar to an X-ray.
Can Addison’s disease be prevented or avoided?
Addison’s disease cannot be prevented or avoided.

Addison’s disease treatment
Treating Addison’s disease usually involves taking prescription hormones. This can include hydrocortisone, prednisone, or cortisone acetate. If your body is not making enough of the hormone aldosterone, your doctor may prescribe fludrocortisone. These medicines are taken every day by mouth (in pill form).

Your doctor may also recommend that you take a medicine called dehydroepiandrosterone. Some women who have Addison’s disease find that taking this medicine improves their mood and sex drive.

If you are experiencing an Addisonian crisis, you need immediate medical care. The treatment typically consists of intravenous (IV) injections of hydrocortisone, saline (salt water), and dextrose (sugar). These injections help restore blood pressure, blood sugar, and potassium levels to normal.

Living with Addison’s disease
Living with Addison’s disease involves learning to live with the unpleasant symptoms. In addition, you need to prepare for the possibility of Addisonian crisis. This is a medical emergency that requires you to:

Carry a medical alert card and bracelet at all times. This gives emergency medical workers information about your condition.
Keep extra medicine with you in case you forget to take your medicine. Ask your doctor for an injectable form of corticosteroids for use in an emergency.
Tell your doctor if your symptoms change or if your medicines stop working the way they used to.
Questions to ask your doctor
Is Addison’s disease hereditary?
Can the severity of my symptoms get worse over time?
Is Addison’s disease rare?
Can Addison’s disease cause long-term kidney failure?
Resources
National Institute of Diabetes and Digestive and Kidney Diseases, Adrenal Insufficiency & Addison’s Disease

U.S. National Library of Medicine, Addison’s Disease

Abdominal Aortic Aneurysm (AAA)

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What is an abdominal aortic aneurysm (AAA)?
The main blood vessel in your body is the aorta. It is a long blood vessel that reaches from your chest into your abdomen. It carries blood from your heart to the rest of your body. The part of the aorta in your abdomen is called the abdominal aorta. It supplies blood to your stomach, pelvis, and legs.

Sometimes an area of a blood vessel wall will get weak. It can start to swell like a balloon and become abnormally large. This is called an aneurysm. If an aneurysm forms in your abdominal aorta and grows too large, your aorta could tear or burst.

Symptoms of an AAA
As the aneurysm develops, there are usually no symptoms. This can go on slowly for years. Often, AAAs don’t cause symptoms unless they leak, tear, or rupture. If this happens, you may experience:

sudden pain in your abdomen, groin, back, legs, or buttocks
nausea and vomiting
abnormal stiffness in your abdominal muscles
problems with urination or bowel movements
clammy, sweaty skin.
If you have these symptoms, call your doctor. Internal bleeding from a ruptured AAA can put you into shock. Shock can be fatal if not treated right away.

What causes an AAA?
Doctors don’t know exactly what causes an AAA. Weaker aorta walls increase your chance of developing an aneurysm. There are many conditions that can weaken the walls of the aorta. These include aging, smoking, and high blood pressure. If any of the following factors apply to you, you are at higher risk of having an AAA.

Being male. Men are more likely than women to develop an AAA.
Age. AAAs are more common in people age 65 or older.
Personal history. If you have had aneurysms of any kind, you are at greater risk of an AAA.
Smoking. Smoking damages and weakens the aorta walls.
High blood pressure. Having high blood pressure weakens the walls of your aorta.
Family history. If any family members have had AAAs, you are at higher risk. You also could get an AAA before you are 65.
Talk to your doctor if you have a higher risk for an AAA, or if you have any of the symptoms.

How is an AAA diagnosed?
Doctors commonly find AAAs by chance during a routine exam. They also find them when doing tests for other issues, including unrelated pain in your abdomen. Doctors recommend an AAA screening for men age 65 to 75 who have ever smoked.

If your doctor finds or thinks you have an AAA, he or she may order tests. Common tests include:

Ultrasound or echocardiogram – These use sound waves to create pictures of the inside of your body.

Computed tomography (CT) scan – The doctor uses X-rays to take pictures of your organs. Dye is injected into your veins so he or she can see them clearly.

Magnetic resonance imaging (MRI) – This test uses magnets and radio waves to create pictures of your organs.

Angiography – This test uses dye and X-rays to look at the inside of your arteries. This can help your doctor see how much damage or blockage there is in your blood vessels.

If your doctor finds or thinks you might have an AAA, he or she might refer to you a specialist for treatment.

Can an AAA be prevented or avoided?
You can’t always prevent an AAA from forming. But there are steps you can take to lower your risk. These include:

Don’t smoke, or try to quit, if you are a smoker.
Eat a healthy diet.
Be physically active.
Manage conditions such as high blood pressure that can be controlled with medicine.
AAA treatment
Treatment for an AAA depends on its size. If your aneurysm is small, it might not need to be treated. Your doctor may just monitor it using routine testing. If your doctor is concerned about it, he or she may prescribe medicine. These can be used to lower blood pressure or relax blood vessels. This can help prevent the AAA from rupturing.

If your aneurysm is large or is growing quickly, you will most likely need surgery. There are 2 main kinds of surgery to remove or repair AAAs:

Open abdominal surgery – This is the most common form of surgery for an AAA. The surgeon will make an incision (cut) in your abdomen. He or she will remove the aneurysm. The removed section of the aorta is replaced with a graft made of man-made material.

Endovascular repair – In this procedure, the doctor inserts a graft into the aorta to strengthen it. He or she will insert a catheter (tube) into your artery through your leg. The graft will be threaded through the aneurysm and expanded. This will reinforce the weak section of the aorta and allow blood to flow normally. This helps keep the AAA from rupturing.

The type of surgery you have depends on many factors. Talk to your doctor about which kind is best for you.

Living with an AAA
If you have an AAA, it is important to get regular medical care. Listen to your doctor and follow your treatment plan. He or she may advise you to avoid lifting heavy objects. Try to avoid highly emotional situations or crises that could raise your blood pressure. Take care of yourself to prevent the aneurysm from bursting or tearing.

Questions to ask your doctor
If I’ve had one AAA, am I likely to experience another?
Are there any lifestyle changes I can make to avoid getting another AAA?
Is watchful waiting safe? Is there a chance the AAA could burst?
Are there any side effects from an AAA that I should be watching for?
What should I do if my pain gets worse?
Should I visit a specialist?
Are there any websites you recommend where I can learn more about AAAs?
Resources
National Heart, Lung, and Blood Institute, Aneurysm

U.S. National Library of Medicine, Aortic Aneurysm