Source: National Institutes of Health – 
Related MedlinePlus Pages: Mycobacterial Infections
Category: Family Health
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ClinicalTrials.gov: Mycobacterium Infections, Nontuberculous
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Check for Substance Use Disorder Symptoms
Take this brief quiz to see if you may have a problem with alcohol or other drug use, and if proven treatment like CBT for Substance Use Disorders may help you.
Use this brief screening tool to see if Cognitive Behavioral Therapy for Substance Use Disorders may be helpful to you. The questions that follow are about your use of alcohol and other drugs. Your responses to these questions will be anonymous, and no information will be collected, saved, or sent over the Internet. Mark the response that best fits you. Answer the questions in terms of your experiences in the past 6 months.
About these questions
The questions you will be asked come from the “Simple Screening Instrument for Substance Abuse,” or “SSI-SA,” questionnaire for short. This is a proven tool for screening for alcohol and other drug use problems. This questionnaire does not provide a diagnosis. Only a health care or mental health care provider can diagnose an alcohol or other drug use condition.
Summary of Your Results
Your responses suggest that you may have some problems related to alcohol or other drugs and that you may benefit from treatment like Cognitive Behavioral Therapy for Substance Use Disorders. Learn more about this proven treatment that has helped many people, including Vets. To find treatment or learn more about your options, visit the Find Treatment section of this website, or visit your health care provider. To learn about treatment resources for other mental health conditions, visit the Additional Resources section of this website.
You report having few problems related to alcohol or other drugs. However, you still may wish to learn more about Cognitive Behavioral Therapy for Substance Use Disorders, which has helped many Vets. To speak with a trained professional about your options, visit the Find Treatment section of this website, or visit your health care provider. To learn about other resources, or about resources for other mental health conditions, visit the Additional Resources section of this website.
You report having very few, if any, problems related to alcohol or other drugs. You may not feel the need for treatment at this time. However, you still may wish to learn more about Cognitive Behavioral Therapy for Substance Use Disorders, which has helped many Vets. To learn about other resources, or about resources for other mental health conditions, visit the Additional Resources section of this website.
If you are in crisis or are in need of immediate help:
If you feel at any time that you might be in danger of harming yourself or someone else or you would like to speak with someone immediately, please know that there are people who care and ready to help right away. There are several options for support right now:
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Call the Veterans and Military Crisis Line at 988 and Press 1.
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Text the Veterans and Military Crisis Line at 838255.
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Chat confidentially online with a Veterans and Military Crisis Line counselor.
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Call 911 or go to the nearest hospital emergency room.
Your privacy is very important. No information that you provide will be kept or stored.
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Urinary Tract Infection in Men
What is a urinary tract infection?
Urinary tract infections involve the parts of the body — the kidneys, ureters, bladder and urethra — that produce urine and carry it out of the body. Urinary tract infections often are classified into two types based on their location in the urinary tract:
- Lower tract infections — These include cystitis (bladder infection) and urethritis (infection of the urethra). Lower urinary tract infections commonly are caused by intestinal bacteria, which enter and contaminate the urinary tract from below, usually by spreading from the skin to the urethra and then to the bladder. Urethritis also may be caused by microorganisms that are transmitted through sexual contact, including gonorrhea and Chlamydia. Another form of male urinary infection is prostatitis which is an inflammation of the prostate.
- Upper tract infections — These involve the ureters and kidneys and include pyelonephritis (kidney infection). Upper tract infections often occur because bacteria have traveled upward in the urinary tract from the bladder to the kidney or because bacteria carried in the bloodstream have collected in the kidney.
Most cases of urinary tract infections occur in women. Of those that occur in men, relatively few affect younger men. In men older than 50, the prostate gland (a gland near the bottom of the bladder, close to the urethra) can enlarge and block the flow of urine from the bladder. This condition is known as benign prostatic hyperplasia or BPH. This condition can prevent the bladder from emptying completely, which increases the likelihood that bacteria will grow and trigger an infection. Cystitis is more common in men who practice anal intercourse and in those who are not circumcised. Other factors that increase the risk of urinary infections include an obstruction, such as that caused by a partial blockage of the urethra known as a stricture, and non-natural substances, such as rubber catheter tubes (as may be inserted to relieve a blockage in the urethra).
Symptoms of a urinary tract infection
A urinary tract infection usually causes one or more of the following symptoms:
- unusually frequent urination
- an intense urge to urinate
- pain, discomfort, or a burning sensation during urination
- awakening from sleep to pass urine
- pain, pressure, or tenderness in the area of the bladder (in the middle of the lower abdomen, below the navel)
- bedwetting in a person who usually had been dry at night
- urine that looks cloudy or smells foul
- fever, with or without chills
- nausea and vomiting
- pain in the side or upper back.
Diagnosing a urinary tract infection
Your doctor will ask about your symptoms and about any previous episodes of urinary tract infection. To fully assess your risk factors, your doctor may ask about your sexual history, including your history and your partner’s history of sexually transmitted diseases, condom use, multiple partners and anal intercourse.
Your doctor will diagnose a urinary tract infection based on your symptoms and the results of a physical examination and laboratory tests of your urine. In a typical urinary tract infection, your doctor will see both white blood cells (infection-fighting cells) and bacteria when he or she examines your urine under a microscope. Your doctor probably will send your urine to a laboratory to identify the specific type of bacteria and specific antibiotics that can be used to eliminate the bacteria.
In men, a rectal examination will allow your doctor to assess the size and shape of the prostate gland. If you are a young man with no sign of an enlarged prostate, your doctor may order additional tests to search for a urinary tract abnormality that increases the likelihood of infection. This is because urinary tract infections are relatively rare in young men with normal urinary tracts. Additional tests may include intravenous pyelography or a computed tomography (CT) scan, which shows an outline of your urinary tract on X-rays; ultrasound; or cystoscopy, an examination that allows your doctor to inspect the inside of your bladder using a thin, hollow tube-like instrument.
Expected duration of a urinary tract infection
With proper treatment, most uncomplicated urinary tract infections begin to improve in one to two days.
Preventing a urinary tract infection
Most urinary tract infections in men cannot be prevented. Practicing safe sex by using condoms will help to prevent infections that are transmitted through sexual contact.
In men with benign prostatic hypertrophy, cutting out caffeine and alcohol or taking certain prescription medications may help to improve urine flow and prevent the buildup of urine in the bladder, which increases the likelihood of infection. Many men with urinary infections due to an enlarged prostate gland require surgery to remove part of the gland. Because this surgery can improve urine flow, it can help prevent infections.
Treating a urinary tract infection
Doctors treat urinary tract infections with a variety of antibiotics. The results of laboratory tests on your urine can help your doctor pick the best antibiotic for your infection. In general, most uncomplicated lower tract infections will be eliminated completely by five to seven days of treatment. Once you finish taking the antibiotics, your doctor may ask for a repeat urine sample to check that bacteria are gone. If an upper tract infection or infection of the prostate is diagnosed, your doctor may prescribe antibiotics for three weeks or longer.
Men with severe upper tract infections may require hospital treatment and antibiotics given through an intravenous catheter (in a vein). This is especially true when nausea, vomiting and fever increase the risk of dehydration and prevent the use of oral antibiotics.
When to call a professional
Call your doctor whenever you have any of the symptoms of a urinary tract infection.
If you are approaching age 50, call your doctor if you notice any of the following: a decrease in the force of your urine stream, difficulty in beginning urination, dribbling after you urinate, or a feeling that your bladder isn’t totally empty after you finish urinating. These could be symptoms of an enlarged prostate, a problem that can be treated effectively before it triggers a urinary tract infection.
Prognosis
Most urinary tract infections can be treated easily with antibiotics. In a man who has a urinary tract abnormality or an enlarged prostate, repeated urinary tract infections may occur as long as the underlying problem continues to interfere with the free flow of urine.
Additional info
National Institute of Diabetes & Digestive & Kidney Disorders
https://www.niddk.nih.gov/Urology Care Foundation
https://www.urologyhealth.org/ -
Self-Care for Vomiting and Diarrhea
Vomiting and diarrhea can make you feel awful. Your stomach and bowels are reacting to an irritant. This might be food, medicine, bacteria, or a virus. Vomiting and diarrhea are 2 ways your body tries to remove the problem from your system. Nausea is a symptom that prevents you from eating. This can give your stomach and bowels time to recover. Self-care can help ease your discomfort.
Drink liquids
Drink or sip liquids. This is so you don’t lose too much fluid (dehydration). To do this:
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Choose clear liquids, such as water or broth.
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Don’t have drinks with a lot of sugar in them. This includes juice and soda. These can make diarrhea worse.
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Don’t have drinks with caffeine and alcohol.
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If you have severe vomiting or diarrhea, don’t drink sports drinks or electrolyte drinks. These don’t have the right mix of water, sugar, and minerals. They can make the symptoms worse. Try an oral rehydration solution.
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Suck on ice chips if nausea makes it hard for you to drink.
When you’re able to eat again
Try these tips:
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As nausea eases and your appetite comes back, slowly go back to your normal diet.
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Ask your provider if you should not eat certain foods.
Medicines
When considering medicines:
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Don’t use medicines to stop diarrhea or vomiting unless your provider tells you to do so. Vomiting and diarrhea can help your body get rid of harmful substances.
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Some medicines can cause vomiting and diarrhea. Talk with your provider about all medicines you take. Ask which ones may cause these symptoms.
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Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can bother your stomach. Don’t use them when you have an upset stomach.
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Some over-the-counter medicines can help control nausea. Others can help soothe an upset stomach. Ask your provider which medicines may help you.
When to call your healthcare provider
Call your provider right away if you have any of these:
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Bloody or black vomit or poop
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Severe, steady belly pain
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Vomiting with a bad headache or stiff neck
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Vomiting after a head injury
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Vomiting and diarrhea together for more than 1 hour
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Can’t sip liquids after more than 12 hours
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Vomiting that lasts more than 24 hours
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Severe diarrhea that lasts more than 2 days
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Fever of 100.4°F (38°C) or higher, or as advised
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Yellow color to your skin or the whites of your eyes (jaundice)
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Can’t pee
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Can’t keep down some oral medicines, such as those for seizures or heart problems
Author: StayWell Custom Communications
Last Annual Review Date:
4/1/2024
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Diffuse Idiopathic Skeletal Hyperostosis | Arthritis Foundation
Diffuse idiopathic skeletal hyperostosis (DISH) is a type of arthritis that affects tendons and ligaments, mainly around your spine. These bands of tissue can become hardened (calcified) and form growths called bone spurs where they connect to your bones. DISH can also cause bone spurs in your hips, knees, shoulders, feet and hands and harden bones throughout your body.DISH, sometimes called Forestier disease, often doesn’t cause symptoms and is usually found when you have an imaging test for another problem. Some people have pain and stiffness in their back that may get worse over time.
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About Tourette Syndrome | Tourette Syndrome
What it is
Tourette syndrome (TS) is a condition of the nervous system. TS causes people to have “tics”.
Tics are sudden twitches, movements, or sounds that people do repeatedly. People who have tics cannot stop their body from doing these things. For example, a person might keep blinking over and over. Or a person might make a grunting sound unwillingly.
Having tics is a little bit like having hiccups. Even though you might not want to hiccup, your body does it anyway. Sometimes people can stop themselves from doing a certain tic for a while, but it’s hard. Eventually the person has to do the tic.
Knowing when tics started and how long symptoms have lasted can help healthcare providers make an accurate diagnosis. Symptoms
The main symptoms of TS are tics. A person can have tics ranging from simple, temporary tics lasting a few weeks or months, to having many complex tics that are long-lasting. Symptoms of TS usually begin when a child is 5 to 10 years of age. The first symptoms often are motor tics that occur in the head and neck area.
The types of tics and how often a person has tics changes a lot over time. Even though the symptoms might appear, disappear, and reappear, these conditions are considered chronic.
In most cases, tics decrease during adolescence and early adulthood and sometimes disappear entirely. However, many people with TS experience tics into adulthood and, in some cases, tics can become worse during adulthood.1
Although the media often portray people with TS as involuntarily shouting out swear words (called coprolalia) or constantly repeating the words of other people (called echolalia), these symptoms are rare, and are not required for a diagnosis of TS.
Risk factors
Scientists do not know the exact cause of TS. Research suggests that it is an inherited genetic condition.23 That means it is passed on from parent to child through genes.
Genes play an important role in a person’s risk of Tourette syndrome. Scientists are studying other possible causes and environmental risk factors that might contribute to TS. Some studies have shown that the following factors might be associated with TS, but additional research is needed to better understand these associations:456
- Smoking during pregnancy
- Pregnancy complications
- Low birthweight
- Infection
Diagnosis
There is no single test, like a blood test, to diagnose TS. Health professionals look at the person’s symptoms to diagnose TS and other tic disorders. The tic disorders differ from each other in terms of the type of tic present (motor or vocal, or combination of the both), and how long the symptoms have lasted. TS can be diagnosed if a person has both motor and vocal tics, and has had tic symptoms for at least a year.
Did you know?
Depending on the type of tics a person has, and how long the tics last, a person might be diagnosed with Tourette syndrome or another type of tic disorder.
There are three types of tic disorders.
Other concerns and conditions
TS often occurs with other conditions. Most children diagnosed with TS also have been diagnosed with at least one additional mental, behavioral, or developmental disorder such as attention-deficit/hyperactivity disorder (ADHD), anxiety, or obsessive-compulsive disorder (OCD). It is important to find out if a person with TS has any other conditions and treat those conditions properly.
Treatment and recovery
Although there is no cure for TS, there are treatments available to help manage the tics. Many people with TS have tics that do not get in the way of their daily life and, therefore, do not need any treatment. However, medication and behavioral treatments are available if tics cause pain or injury; interfere with school, work, or social life; or cause stress.
What CDC is doing
CDC works with partners to better understand TS, including the prevalence of TS, the quality of life among people affected by TS, and the impact of TS on parenting, relationships, and education.
Funded partners are helping CDC to track persistent tic disorders (PTD) including TS among children, adolescents, and young adults. This will allow us to better understand the public health impact of these disorders (such as healthcare costs and physical health outcomes) and provide data that can be used to inform education and outreach activities to improve the health and well-being of individuals with tic disorders and their families.
CDC is also conducting studies of screening and diagnostic tools to improve identification of children with tics. Results from this research are used to better inform public health efforts to improve the lives and health outcomes of people affected by TS, to implement education programs to help improve the quality of life of those with TS and their families, and to inform future research.
CDC’s latest data on Tourette syndrome.
Learn about identifying TS and other tic disorders.
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Dyssynergic Defecation: About a Common Cause of Chronic Constipation
Introduction
Constipation is defined as the experience one of more problems with bowel movements (BMs) such as
- infrequent bowel movements,
- hard and difficult to pass bowel movements,
- incomplete bowel movements,
- straining to have a bowel movement,
- prolonged duration of time needed to evacuate a bowel movement,
use of digital maneuvers (use of fingers) to assist bowel movement. - A number of factors can cause constipation that is persistent or long-lasting (chronic constipation).
Among the most common is a condition called dyssynergic defecation. About 40% of chronic constipation is caused by this condition.
What is Dyssynergic Defecation?
Dyssynergic defecation is an acquired condition in which there is a problem coordinating the abdominal, rectal and anal muscles (Pelvic Floor) to achieve a normal and complete bowel movement.
The pelvic floor is a group of muscles located at the lower part of the abdomen, between the hip bones, that supports pelvic organs such as the rectum, uterus, and urinary bladder. One of its most important functions is to help make possible our ability to have orderly bowel movements.
Working together, the pelvic floor nerves and muscles help maintain the ability to control movements of the bowels and bladder (also known as continence) until we have a bowel movement. Failure of this to happen can lead to problems of constipation
When do People Develop Dyssynergic Defecation?
A survey of 100 patients with the condition found that in nearly one-third (31%) the problem began in childhood. About an equal number (29%) appeared to have developed the problem after a particular event, such as pregnancy or an injury. In the remaining 4 out of 10 persons (40%), no cause was identified that may have brought on the condition in adulthood.
It may be that too much straining to expel hard stools over time is a factor that may lead to dyssynergic defecation.
Why do People Develop Dyssynergic Defecation?
Muscles in the abdomen, rectum, anus, and pelvic floor must all work together in order to facilitate defecation.
Most patients with dyssynergic defecation show an inability to coordinate these muscles. Most often this problem of coordination consists either of impaired abdominal or rectal muscle contraction together with tightening rather than relaxing of the anal muscles during defecation, or not enough relaxation of the anal muscles. This lack of coordination (dyssynergia) of the muscles that are involved in defecation is primarily responsible for this condition.
In addition, at least one-half (50-60%) of patients with dyssynergic defecation also show evidence of a decrease in sensation in the rectum. In other words, their ability to perceive the arrival of a bowel movement in the rectum is abnormal. This condition is also known as rectal hyposensitivity.
What are the Symptoms of Dyssynergic Defecation?
People with dyssynergic defecation have a variety of bowel symptoms. As with many conditions involving the bowel, individuals may hesitate to speak plainly about these symptoms. Some may feel embarrassed to even mention bowel or stool-related matters. Others may simply not know how to describe their symptom experiences, or know what to discuss.
It is important for individuals to keep in mind that anything out of the ordinary, rather than being a source of embarrassment, is often the very reason for the visit to their doctor.
It is necessary to speak plainly to the healthcare provider so they can most effectively diagnose and treat the problem. It is not unusual, for example, for a person with long-term constipation to find it necessary to use their finger to move stool out of the anus (providers call this disimpacting stool with digital maneuvers).
Another common example is for women to use their fingers to press on their vagina to move stool (providers call this vaginal splinting). In other words, these are medical signs that are meaningful to a healthcare provider.
Patients and doctors both benefit from establishing a relationship of comfort and trust. Open communication is essential. It may be easier to write down the troublesome signs and symptoms before the doctor visit. The use of a symptom questionnaire or stool diary is a helpful way to communicate and identify the exact nature of a bowel problem.
A number of studies have found that the following are common symptoms or signs associated with dyssynergic defecation, with 2 out of 3 or more of individuals reporting:
- Excessive straining
- A feeling of incomplete evacuation
- The passage of hard bowel movements
- A stool frequency of less than 3 bowel movements per week
- The use of digital maneuvers (fingers) to help have a bowel movement.
- Prolonged duration of sitting on the toilet.
- Making multiple visits a day to have a bowel movement.
Backache, heartburn, and anorectal surgery have been noted as more likely in patients with pelvic floor dysfunction. However, symptoms alone are usually not enough to predict dyssynergic defecation.
Learn More about Dyssynergic Defecation
Adapted from “Dyssenergic Defecation: Questions and Answers About a Common Cause of Chronic Constipation”– An IFFGD Publication #237 by Satish S.C. Rao, MD, PhD, FRCP(LON), AGAF, Chief, Section of Gastroenterology/Hepatology and Director, Digestive Health Center, Medical College of Georgia, Georgia Regents University, Augusta, GA.
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Cholecystectomy | Johns Hopkins Medicine
What is a cholecystectomy?
A cholecystectomy is surgery to remove your gallbladder. The gallbladder is a small organ under your liver. It’s on the upper right side of your belly (abdomen). The gallbladder stores a digestive juice called bile that is made in the liver.
There are two types of surgery to remove the gallbladder:
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Open (traditional) method. In this method, 1 cut (incision) about 4 to 6 inches long is made in the upper right-hand side of your belly. The surgeon finds the gallbladder and takes it out through the incision.
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Laparoscopic method. This method uses 3 to 4 very small incisions. It uses a long, thin tube called a laparoscope. The tube has a tiny video camera and surgical tools. The tube, camera, and tools are put in through the incisions. The surgeon does the surgery while looking at a TV monitor. The gallbladder is removed through one of the incisions.
A laparoscopic cholecystectomy is less invasive. That means it uses very small incisions in your belly. There is less bleeding. And the recovery time is usually shorter than it is for open surgery.
In some cases, the laparoscope may show that your gallbladder is very diseased. Or it may show other problems. Then the surgeon may have to use an open surgery method to remove your gallbladder safely.
Why might I need a cholecystectomy?
A cholecystectomy may be done if your gallbladder:
Gallbladder problems may cause pain which:
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Is usually on the right side or middle of your upper belly
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May be constant or may get worse after a heavy meal
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May sometimes feel more like fullness than pain
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May be felt in your back and in the tip of your right shoulder blade
Other symptoms may include nausea, vomiting, fever, and chills. The symptoms of gallbladder problems may look like other health problems. Always see your healthcare provider to be sure. Your healthcare provider may have other reasons to recommend a cholecystectomy.
What are the risks of a cholecystectomy?
Some possible complications of a cholecystectomy may include:
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Bleeding
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Infection
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Injury to the tube (bile duct) that carries bile from the gallbladder to the small intestine
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Liver injury
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Scars and a numb feeling at the incision site
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A bulging of organ or tissue (hernia) at the incision site
During a laparoscopic procedure, surgical tools are put into your belly. This may hurt your intestines or blood vessels.
You may have other risks that are unique to you. Be sure to discuss any concerns with your healthcare provider before the procedure.
How do I get ready for a cholecystectomy?
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Your healthcare provider will explain the procedure to you. Ask them any questions you have.
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You may be asked to sign a consent form that gives your healthcare provider permission to do the procedure. Read the form carefully and ask questions if anything is not clear.
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Your healthcare provider will ask questions about your past health. They may also give you a physical exam. This is to make sure you are in good health before the procedure. You may also need blood tests and other diagnostic tests.
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You must not eat or drink for 8 hours before the procedure. This often means no food or drink after midnight.
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Tell your healthcare provider if you are pregnant or think you may be pregnant.
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Tell your healthcare provider if you are sensitive to or allergic to any medicines, latex, tape, and anesthesia medicines (local and general).
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Tell your healthcare provider about all the medicines you take. This includes both over-the-counter and prescription medicines. It also includes vitamins, herbs, and other supplements.
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Tell your healthcare provider if you have a history of bleeding disorders. Let them know if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other medicines that affect blood clotting. You may need to stop taking these medicines before the procedure.
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If this is an outpatient procedure, you will need to have someone drive you home afterward. You won’t be able to drive because of the medicine given to relax you before and during the procedure.
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Follow any other instructions your healthcare provider gives you to get ready.
What happens during a cholecystectomy?
You may have a cholecystectomy as an outpatient or as part of your stay in a hospital. The way the surgery is done may vary depending on your condition and your healthcare provider’s practices.
A cholecystectomy is generally done while you are given medicines to put you into a deep sleep (under general anesthesia).
Generally, a cholecystectomy follows this process:
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You will be asked to take off any jewelry or other objects that might get in the way during surgery.
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You will be asked to remove clothing and be given a gown to wear.
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An IV (intravenous) line will be put in your arm or hand.
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You will be placed on your back on the operating table. The anesthesia will be started.
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A tube will be put down your throat to help you breathe. The anesthesiologist will check your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
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If there is a lot of hair at the surgical site, it may be trimmed off.
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The skin over the surgical site will be cleaned with a sterile (antiseptic) solution.
Open method cholecystectomy
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An incision will be made. The incision may slant under your ribs on the right side of your abdomen. Or it may be made in the upper part of your abdomen.
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Your gallbladder is removed.
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In some cases, one or more drains may be put into the incision. This allows drainage of fluids or pus.
Laparoscopic method cholecystectomy
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About 3 or 4 small incisions will be made in your abdomen. Carbon dioxide gas will be put into your abdomen so that it swells up. This lets the gallbladder and nearby organs be easily seen. This can cause referred pain in your shoulder.
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The laparoscope will be put into an incision. Surgical tools will be put through the other incisions to remove your gallbladder.
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When the surgery is done, the laparoscope and tools are removed. The carbon dioxide gas is let out through the incisions. Most of it will be reabsorbed by your body.
Procedure completion with both methods
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The gallbladder will be sent to a lab for testing.
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The incisions will be closed with stitches or surgical staples.
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A sterile bandage or dressing or adhesive strips will be used to cover the wounds.
What happens after a cholecystectomy?
In the hospital
After the procedure, you will be taken to the recovery room to be watched. Your recovery process will depend on the type of surgery and the type of anesthesia you had. Once your blood pressure, pulse, and breathing are stable and you are awake and alert, you will be taken to your hospital room.
A laparoscopic cholecystectomy may be done on an outpatient basis. In this case, you may be discharged home from the recovery room. You will get pain medicine as needed. A nurse may give it to you. Or you may give it to yourself through a device connected to your IV line.
You may have a thin plastic tube that goes through your nose into your stomach. This is to remove air that you swallow. The tube will be taken out when your bowels are working normally. You won’t be able to eat or drink until the tube is removed.
You may have one or more drains in the incision if an open procedure was done. The drains will be removed in a day or so. You might be discharged with the drain still in and covered with a dressing. Follow your healthcare provider’s instructions for taking care of it.
You will be asked to get out of bed a few hours after a laparoscopic procedure or by the next day after an open procedure. Depending on your situation, you may be given liquids to drink a few hours after surgery. You will slowly be able to eat more solid foods as tolerated. You should schedule a follow-up visit with your healthcare provider. This is usually 2 to 3 weeks after surgery.
At home
Once you are home, it’s important to keep the incision clean and dry. Your healthcare provider will give you specific bathing instructions. If stitches or surgical staples are used, they will be removed during a follow-up office visit. If adhesive strips are used, they should be kept dry and usually will fall off within a few days.
The incision and your abdominal muscles may ache, especially after long periods of standing. If you had a laparoscopic surgery, you may feel pain, such as shoulder pain, from any carbon dioxide gas still in your belly. This pain may last for a few days. It should feel a bit better each day.
Take a pain reliever as recommended by your healthcare provider. Aspirin or other pain medicines may raise your risk of bleeding. Be sure to take only medicines your healthcare provider has approved.
Walking and limited movement are generally fine. But you should avoid strenuous activity. Your healthcare provider will tell you when you can return to work, or when pediatric patients can return to school, and go back to normal activities.
Call your healthcare provider if you have any of the following:
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Fever or chills
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Redness, swelling, bleeding, or other drainage from the incision site
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More pain around the incision site
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Yellowing of your skin or the whites of your eyes (jaundice)
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Belly or abdominal pain, cramping, or swelling
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No bowel movement or gas for 3 days
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Pain behind your breastbone
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The humble gallbladder – Harvard Health
In the hierarchy of digestive organs, you might first list the stomach, liver, or colon. But there’s a pear-shaped sac tucked under your liver that barely gets a second thought: the lowly gallbladder.
This small but mighty organ plays an important role in helping us digest food, but we often don’t acknowledge it unless something goes wrong — which happens in about 15% of American adults, according to the National Institutes of Health (NIH). Yet gallbladder disease — which includes stones, inflammation, infection, or blockage — can lead to excruciating pain or even life-threatening complications down the line.
The gallbladder essentially serves as a storage room for bile, squeezing the fluid into the small intestine to help digest the fats we consume. It makes sense, then, that the organ might struggle when our diet is heavy in fatty or fried foods. We can live without a gallbladder, but it can’t stay in peak performance mode without diligent care, says Dr. William Brugge, a professor of medicine at Harvard Medical School.
“I think people generally try to ignore their gallbladder,” Dr. Brugge says. “It doesn’t have as squeamish a reputation as the colon or rectum, but it’s down there on the list.”
Tactics to promote gallbladder health
Keeping your gallbladder healthy involves a similar approach to keeping the rest of your body in optimal shape. These familiar suggestions include:
Eat more fruits and vegetables. They’re rich in nutrients such as vitamin C, folic acid, and magnesium, which may lower the risk of gallbladder disease. Fiber-filled fruits and vegetables also don’t strain the gallbladder, since they contain little or no fat.
Favor lean proteins. Opting for poultry, lean meat, and fish dishes that are baked or broiled — not fried — can lower your gallstone risk. Limit or avoid full-fat dairy products and red or processed meats.
Maintain a healthy weight. Overweight or obesity can make you prone to gallstones.
Risk factors
Aside from a high-fat diet, other risk factors for gallbladder disease include overweight or obesity, a family history of gallbladder issues, Native American or Latino heritage, and being 40 or older. Women are twice as likely as men to develop gallstones, which top the list of gallbladder problems. Extra estrogen, particularly during pregnancy, slows the gallbladder’s ability to empty, letting bile pool, Dr. Brugge says.
Gallstones develop when bile or related fluids form hardened stonelike lumps that can grow and multiply. Attacks of agonizing pain result when gallstones get larger or block bile ducts. Other symptoms include pain between the shoulder blades, nausea, vomiting, fever, chills, bloating, indigestion, and sweating. About a quarter of people diagnosed with gallstones each year need treatment, which is usually surgery.
“After eating a particularly heavy or fatty meal, you may have severe pain — far more than gas or cramps — that might last for an hour or two,” Dr. Brugge says.
Serious complications
Because bile ducts connect the gallbladder to other digestive organs, these surrounding structures can also suffer complications from gallbladder disease. Problems include cholangitis (bile duct inflammation), cirrhosis (scarring of the liver), and pancreatitis (inflammation of the pancreas).
But the most dangerous complication, Dr. Brugge says, is gallbladder inflammation called cholecystitis. It results from a gallstone getting stuck in the gallbladder, which becomes infected and causes searing pain. “It’s a pretty dramatic illness,” he says. “The gallbladder can rupture or leak infected bile, and the infection can spread through the body. It can be fatal.”
New evidence suggests gallstones may also raise the risk of developing cancers of the liver, bile duct, and pancreas. A study published online June 17, 2022, by the British Journal of Cancer tracked more than 115,000 women and nearly 50,000 men for up to 30 years, asking about their history of gallstones at the study’s start and every other year afterward. Compared with people without gallstones, those who got them were 60% more likely to develop liver cancer, more than four times as likely to develop bile duct cancer, and 13% more likely to develop pancreatic cancer.
Gallbladder cancer itself is relatively rare, diagnosed in about 12,200 Americans each year. “It’s very deadly, but not very common,” Dr. Brugge says.
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Oral Corticosteroids |AAFA.org
A 2018 Asthma and Allergy Foundation of America (AAFA) survey of 519 patients with asthma found that nearly 85 percent used at least one course of OCS in the previous 12 months and 64 percent had done so two or more times. Patients who take two or more courses of OCS in a 12-month span may have severe or poorly controlled asthma and should speak with a qualified asthma specialist.
How Do You Know If Your Asthma Is Not Under Control?
If your asthma is well-controlled, you have a better chance of recovering faster or avoiding complications from an illness. Keep the Rules of Two® in mind:
- Do you take your quick-relief inhaler more than two times a week?
- Do you awaken at night with asthma more than two times a month?
- Do you refill your quick-relief inhaler more than two times a year?
- Do you measure your peak flow at less than two times 10 (20%) from baseline with asthma symptoms?
If any of these apply to you, talk with your health care provider.
Also, if you are taking oral corticosteroids (such as prednisone) two or more times per year, ask your health care provider about other options.
While OCS can be an important tool in managing asthma in certain cases, their use should always be carefully monitored by an asthma specialist or a primary care provider with expertise in asthma.
Your health care provider may run more tests or have you try other medicines. Biologics are an innovative type of treatment used to treat severe, uncontrolled asthma that may reduce the number of asthma attacks you have and reduce the need for OCS. Biologic treatments are given as shots or infusions every few weeks. The treatment targets and blocks a cell or protein in your body that leads to airway inflammation.