If you find yourself lying awake in bed, you may need a sleep reboot. Try this:
Try to take your mind off any racing thoughts. Picture a relaxing scene that involves sleep and build that scene in your mind. So, let’s say your scene has you lying in a beach hammock under the stars. Imagine what the waves sound like. Are there other sounds, like palm trees rustling? What sensations do you feel (like the hammock swaying, or maybe a warm breeze blowing)? Is anyone else there with you? Focus completely on this scene for a while.
Get up for a short time. If you’ve been lying awake for a while, get out of bed and do something relaxing that might make you feel drowsy — like reading, listening to quiet music, using a meditation or sleep app, or doing gentle yoga. Keep the lights low and go back to bed after 20 or 30 minutes (or sooner if you start feeling sleepy).
Avoid technology, like phones, computers, or TV. Brightly lit screens can trick your brain into thinking it’s time to wake up. And anything that stimulates your brain — from texting to video games — also can kick your body into wake-up mode.
If you regularly have trouble falling asleep, work on training your body to wind down and relax with a pre-sleep routine each night. This could mean taking a shower, reading, or listening to quiet music.
Set other good sleep habits will make it easier to fall asleep at night, like:
going to bed at the same time each night and waking up around the same time in the morning (even on weekends)
shutting down technology
keeping your room cool and dark
Being active during the day can help you sleep better, as long as you don’t exercise too close to your bedtime. Caffeine will keep you lying awake at night so avoid coffee, tea, energy drinks and anything with caffeine in it for several hours before bed.
It can help to treat sleep like any other goal: Build a plan that helps you focus on it and get the results you want!
A bowel (intestinal) obstruction is a serious condition that occurs when the small or large intestine becomes blocked. The blockage stops food and stool (poop) from moving through the intestines. The intestine may be partly or completely blocked and can sometimes be blocked in two places. Bowel obstructions can be life-threatening and require immediate medical attention.
A bowel obstruction may occur soon after cancer treatment ends or many months or years later. Bowel obstruction is most common in people with advanced cancer.
What causes bowel obstruction in people with cancer?
Bowel obstruction in people with cancer may be caused by:
Cancer treatment. Some types of cancer treatment can cause bowel obstruction:
Surgery on the abdomen or pelvis may lead to scar tissue, also called adhesions, that form after surgery. Adhesions can cause the intestines to bind together, creating a blockage.
Radiation therapy directed at the abdomen can damage the intestines, leading to scar tissue, inflammation, radiation enteritis, and irritation that can block the bowel.
A malignant bowel obstruction happens when a tumor forms in the intestines and blocks the flow of waste. The tumor may be from colon or rectal cancer or from cancer that has spread to the intestines from another part of the body.
Cancer itself. Cancers that form in the abdomen, such as colon, ovarian, pancreatic, or stomach cancer, are more likely than other cancer types to cause a bowel obstruction. A bowel obstruction caused by cancer itself is called a malignant bowel obstruction. Cancer can cause a bowel obstruction in different ways:
A tumor that forms in or presses on the bowels can cause a bowel obstruction. A tumor can also cause a bowel obstruction if it grows in an area that affects the nerves that control the movement of food through the intestines.
Advanced cancer can cause a bowel obstruction when cancer spreads to the bowels from another place in the body. Advanced cancer is the most common cause of malignant bowel obstruction.
When an obstruction starts, the intestines may be partly blocked, causing a few mild symptoms. As the obstruction gets worse, your symptoms may happen more often and become more severe. You may have frequent vomiting, extreme bloating, and intense abdominal pain. These are signs of a complete obstruction, in which stool and gas are mostly or totally blocked from leaving the body.
How is bowel obstruction diagnosed?
Finding the cause of a bowel obstruction and the place where the intestine is blocked is important so your doctor can recommend treatment. Your doctor will ask about your symptoms and do a physical exam. They may also use the following tests and procedures to diagnose a bowel obstruction and suggest treatment options:
CT scan (CAT scan) uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body from different angles. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This scan helps doctors find the cause and exact location of the obstruction. It is also called computed tomography, computerized tomography, or computerized axial tomography.
Abdominal x-ray is an x-ray of the organs inside the abdomen. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. It can also show the location of the obstruction, but it is not as sensitive as a CT scan.
Blood tests, such as a complete blood count and electrolyte panel, show if you are dehydrated or have an electrolyte imbalance or infection. These problems may be caused by a bowel obstruction.
Urinalysis checks the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells. A urinalysis shows your fluid levels, signs of infection, and other problems that may be caused by a bowel obstruction.
Treating a bowel obstruction
If you have a bowel obstruction, you will need to be treated in a hospital. Treatment for a bowel obstruction depends on what caused the blockage and whether the intestines are partly or completely blocked. If you have a complete blockage, you will probably need surgery. Partial obstructions may clear up with nonsurgical treatments.
Treatment for a bowel obstruction may include:
Bowel rest. This is when you avoid eating and drinking to keep the obstruction from getting worse. Bowel rest or a liquid diet that is easy on your intestines can help your body clear the blockage. You may also receive fluid replacement therapy (IV fluids) to help the fluids and electrolytes in your body return to normal.
Nasogastric tube. This tube is inserted through the nose and esophagus into the stomach to relieve pressure caused by a bowel obstruction by removing fluid and gas from the digestive system. A nasogastric tube helps control nausea, vomiting, and pain related to the obstruction and may help your body clear the blockage.
Stent. This is a tube placed in the intestine to open the blocked area. Stents relieve bowel obstruction symptoms by temporarily opening the bowels to let food, waste, and gas pass through the body. Stents are most often used to treat bowel obstructions caused by cancer, but they may also be used for obstructions with other causes.
Surgery. If a bowel obstruction does not go away with other treatments or if you have a complete blockage, you may need surgery to remove the obstruction. For an obstruction caused by cancer, surgery will include removing the tumor that is causing the blockage. Your doctor will talk with you about your overall health and potential risks and benefits of surgery to help you decide if surgery is right for you.
Gastrostomy tube. A tube that helps release fluid and air from the stomach to relieve symptoms caused by the obstruction. A tube is inserted through the wall of the abdomen directly into the stomach. The gastrostomy tube can be attached to a drainage bag with a valve. When the valve is open, fluid and air can leave the stomach. Gastrostomy tubes are most often used to treat bowel obstructions caused by cancer.
Antibiotics. Sometimes a bowel obstruction causes a tear in the intestines that lets fluids leak into the abdomen. These fluids can cause your body to have an extreme immune response to an infection (sepsis). Antibiotics can help prevent tissue damage, organ failure, or death from sepsis.
Antinausea and pain medicines. These can treat or control nausea, vomiting, and pain caused by a bowel obstruction.
Considerations for treating a malignant bowel obstruction
If you have a bowel obstruction caused by cancer (also called malignant bowel obstruction), talk to your health care team about available treatments and your goals of care. In most cases, treatments for malignant bowel obstructions relieve symptoms and improve quality of life but may not help you live longer from cancer. You and your family may need to make difficult decisions about your care at this time. If you choose care meant to relieve symptoms over more aggressive treatments, you can learn more about Choices for Care When Treatment May Not Be an Option.
Talking with your doctor about bowel obstruction
If you think you have a bowel obstruction, contact your doctor right away. They can help you decide on a treatment that is right for you.
Questions to ask your provider about bowel obstruction:
What is causing the bowel obstruction?
What treatments are available to me?
What are possible complications of treatments I may receive for bowel obstruction?
What foods should I eat or avoid?
How much liquid should I drink each day?
What symptoms or problems should I call you about?
Will I be at risk of future bowel obstructions?
Getting support if you have a bowel obstruction
Side effects like bowel obstruction can be hard to deal with, both physically and emotionally. It’s important to ask for support from your health care team. They can help you prepare for and make it through difficult times. Learn more about ways to cope with cancer, including ways to adjust to daily life during cancer treatment.
For family members and friends who are caring for someone with cancer, you may find these suggestions for caregivers to be helpful.
How a caregiver can help
Help the person you are caring for eat and drink the foods and liquids their doctor has recommended. Many people treated for a bowel obstruction will need to be on a liquid diet while they recover.
Provide the person you are caring for with a heating pad for their belly that can help relieve pain and cramping.
Talk with the person you are caring for about their goals of care, especially if they have a malignant bowel obstruction, to help them decide on a treatment that is right for them.
Carefully review follow-up care with the person’s doctor to learn what to expect after treatment and how you can help.
To find out which medicine is right for you, talk to your family doctor. They can tell you about the benefits and risks. Antacids and acid reducers rarely cause side effects. If they do, the side effects usually are minor and go away on their own. These may include headaches, nausea, constipation, or diarrhea.
Talk to your doctor before taking antacids if you have kidney disease. You should avoid any antacid that contains calcium carbonate or aluminum hydroxide and magnesium carbonate unless your doctor recommends it.
Talk to your doctor before taking a proton pump inhibitor if:
You are elderly or have immune system problems. PPIs can increase your risk for pneumonia.
You are a postmenopausal woman. PPIs reduce calcium absorption and increase your risk for osteoporosis.
You have been treated for a Clostridium difficile (C. diff.) infection in the past. PPIs may increase the risk that your infection returns.
If you are over the age of 55 and require long-term PPI treatment, your doctor may refer you for an EGD (esophagogastroduodenoscopy). This procedure examines the lining of the esophagus, stomach, and upper small intestine. If you have significant reflux, your doctor also may test you for a bacteria called H. pylori prior to trying you on PPIs.
Things to consider
Do not use more than 1 antacid or acid reducer at a time unless your doctor says it’s okay. Store all medicines up and away, out of reach and sight of young children. Keep medicines in a cool, dry place. This helps prevent them from becoming less effective before they expire. Do not store medicines in bathrooms, which often are hot and humid.
When to see the doctor
Let your doctor know how the OTC medicines work for you. If your symptoms do not improve or get worse, the doctor may suggest a prescription medicine. If possible, try not to take PPIs long-term. These can increase your risk of certain health conditions, such as osteoporosis, kidney disease, and dementia.
Tell your doctor if you have any of the following symptoms. They may be signs of a more serious problem.
Bloody or black stools
Bloody vomit
Heartburn that has not improved after 2 weeks of treatment with OTC medicines
Trouble swallowing or pain when you swallow
Unplanned weight loss
If you have chest pain, shortness of breath, dizziness, and pain in your arms, you may be having a heart attack. Call 911 or go to the emergency room right away.
Questions to ask your doctor
What type of OTC medicine is best for me to relieve heartburn and acid reflux?
How much medicine can I take and how often?
What are the side effects and risks of these OTC medicines?
Are there any health conditions that prevent me from taking OTC medicines?
The next time you reach for a nonprescription drug to treat your upset stomach or heartburn, consider whether you should use one of the many antacids that don’t have aspirin.
Why? Aspirin-containing medicines to treat heartburn, sour stomach, acid indigestion or upset stomach can cause stomach or intestinal bleeding, especially in some people, warns the U.S. Food and Drug Administration.
Aspirin is commonly used to reduce pain and fever. It is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding, including in the stomach and gastrointestinal tract (digestive tract).
“We’re focusing on bleeding risk specifically with antacid-aspirin products used to treat upset stomach or heartburn. We’re not telling people to stop taking aspirin altogether,” says Karen Murry, M.D., Deputy Director of the Office of Nonprescription Drugs at the FDA.
Cases of bleeding are rare. When the FDA reviewed its Adverse Event Reporting System database, it found new cases of serious bleeding caused by aspirin-containing antacid products despite an agency warning in 2009 about such a risk. Some of those patients required a blood transfusion.
“Take a close look at the Drug Facts label. If the product has aspirin, consider choosing something else for your stomach symptoms,” Murry says. “Unless people read the Drug Facts label when they’re looking for stomach symptom relief, they might not even think about the possibility that a stomach medicine could contain aspirin.”
How will you know what over-the-counter (OTC, or nonprescription) medicine to take to get relief from indigestion? The Drug Facts label will not only tell you if the medicine contains aspirin but also will list the risk factors for bleeding. If the medicine has aspirin, consider finding another product. There are plenty of stomach medicines that don’t contain aspirin.
Who’s at Higher Risk of Bleeding
Because aspirin thins the blood, the FDA believes the aspirin in these combination medicines is contributing to major bleeding events. People with one or more risk factors have a higher chance of serious bleeding with aspirin-containing antacid products.
You are at higher risk for bleeding with these products if you:
Are 60 or older.
Have a history of stomach ulcers or bleeding problems.
Take drugs that reduce the ability of your blood to clot (also known as anticoagulants or blood-thinning drugs).
Take steroid medicine, such as prednisone, to reduce inflammation.
Take other medicines containing NSAIDs, such as ibuprofen or naproxen.
Drink three or more alcoholic drinks every day.
Warning signs of stomach or intestinal bleeding include feeling faint, vomiting blood, passing black or bloody stools, or having abdominal pain. Those are signs that you should consult a health care professional right away.
What if you’ve been taking these products for a long time?
“Some people may have been taking aspirin-containing antacid products frequently for a long time. Apart from the bleeding risk, it’s not normal to have frequent or chronic upset stomach or heartburn. You should talk to a health care professional if that’s happening,” Murry says.
Take aspirin regularly? If your health care professional has advised you to take an aspirin a day to help prevent a heart attack or other condition, don’t stop without talking with them first. “Make sure you discuss what kind of medicine you can take in case you get an upset stomach,” Murry says.
How to Settle an Upset Stomach
People have many alternatives for treating heartburn, sour stomach, acid indigestion and upset stomach. Read the Drug Facts label and look for products that contain an “antacid” or “acid reducer.”
For example, there are numerous nonprescription medicines that contain only an antacid, such as calcium carbonate, magnesium hydroxide, or another antacid,” Murry says. These products can be used to treat heartburn, sour stomach, acid indigestion and upset stomach.
For frequent heartburn, there are acid reducers, such as proton pump inhibitors (esomeprazole, lansoprazole, omeprazole), or H2 blockers (cimetidine, famotidine).
Child insomnia is best treated by having the adult set firm limits. If bedtime is 8 p.m., then the child should be in bed by 8 p.m. A bedtime routine can be helpful but needs to not extend past bedtime. Routines of a snack, bath, and book reading are appropriate. Then the child should go to bed. There should be no reason for the child to get out of bed over and over again. If the child resists, you can take away things the child enjoys or create an award system as an incentive. A more strictly enforced bedtime can be achieved with consistent enforcement. This will produce an improved sleep pattern and will benefit the child.
Young children should fall asleep in their cribs or beds without being rocked to sleep. If a child must be rocked to sleep, then the child will not learn how to go to sleep without help. Falling asleep or falling back to sleep on their own is a skill that a child can learn. It is normal for a child to wake up during the night. Adults even wake up for a few minutes several times per night. Helping a child learn to fall asleep in bed benefits both the child and the adult.
Pancreatitis is an inflammation (irritation and swelling) of the pancreas. With treatment, most kids with pancreatitis (pan-kree-eh-TYE-tis) recover fully within a week or so.
What Are the Types of Pancreatitis?
Pancreatitis can be acute (last only a few days) or chronic (long-lasting or happening more than once). In kids, it’s usually acute and doesn’t come back.
What Are the Signs & Symptoms of Pancreatitis?
Kids with pancreatitis usually have sudden, severe pain in the upper belly. They also might have pain in the back, chest, or sides.
Other pancreatitis signs include:
Children with chronic pancreatitis may also have:
Some kids who have repeated episodes of acute pancreatitis can develop chronic pancreatitis.
What Does the Pancreas Do?
The pancreas is a large gland that sits behind the stomach. It makes digestive enzymes that are released into the small intestine to help break down food. The pancreas also makes insulin and glucagon, two hormones that help control blood sugar levels.
What Causes Pancreatitis?
Common causes of pancreatitis in kids include:
gallstones (stones in the gallbladder) that can block ducts (tubes) that carry enzymes from the pancreas
infections
some medicines
very high triglycerides (a type of fat in the blood)
Some medical conditions or illnesses, such as cystic fibrosis or celiac disease, can increase a child’s risk for pancreatitis. Sometimes, the cause of pancreatitis isn’t found.
How Is Pancreatitis Diagnosed?
To diagnose pancreatitis, doctors will order blood tests, including tests that measure the pancreatic enzymes amylase and lipase. If these levels are high, an abdominal ultrasound can help the doctor check the liver and pancreas and look for gallstones.
Other tests, such as a CAT scan or MRI, can check for inflammation or damage to the pancreas.
How Is Pancreatitis Treated?
Most kids with pancreatitis are treated in the hospital with intravenous (IV) fluids, nutrition, and pain medicine. They’re watched carefully by the care team to make sure they’re getting better and that no other problems develop.
Some kids with very mild pancreatitis who can eat and drink without a problem and don’t have a lot of pain can be treated at home.
Some children with pancreatitis need a procedure called endoscopic retrograde cholangiopancreatography (ERCP). ERCP lets doctors see the ducts in the pancreas and liver. During the ERCP, doctors can remove gallstones or find and treat other causes of pancreatitis.
What Problems Can Happen?
Most children with acute pancreatitis recover without any problems. Fluid in and around the pancreas can happen, but usually gets better on its own. Sometimes, though, doctors need to drain the fluid.
Kids with chronic pancreatitis have trouble digesting food and usually need to take pancreatic enzyme supplements. Chronic pancreatitis may lead to diabetes, but this usually takes many years to happen.
How Can Parents Help?
Help your child recover by following the care team’s advice for what your child should eat and drink, whether they should take any medicines, and when to follow up.
If you have acute pancreatitis, you may need to stay in the hospital for a few days. There you can get intravenous (IV) fluids, antibiotics, and medicine to relieve pain. Most mild cases of pancreatitis clear up with treatment and rest.
If you have a more severe case of pancreatitis, you may need other treatment. This treatment would depend on the cause of the pancreatitis but could include:
Gallbladder removal. If you have gallstones, you may need to have your gallbladder removed.
Other procedures. If you have an abscess or pseudocyst that is infected, your doctor may need to drain it. He or she can remove damaged tissue from your pancreas if that is needed. They can also do other procedures to treat problems with the pancreatic and bile ducts.
If you have chronic pancreatitis, your treatment plan will help relieve pain, improve how well your pancreas works, and manage complications. It may include:
A low-fat diet
Medicine to relieve pain
Insulin to help with high blood sugar levels
Enzyme tablets (pills that help you digest food)
Vitamins if your body doesn’t absorb nutrients well
It is also possible that someone with chronic pancreatitis would need surgery. This could help relieve pressure or a blockage in a pancreatic duct. Surgery could also be used to remove a damaged or infected part of your pancreas.
People who have pancreatitis should not drink alcohol or smoke. Some people develop diabetes or cancer of the pancreas because of the damage caused by chronic pancreatitis. These conditions need separate treatment.
Are your eyes tired, dry, or achy? Many factors can contribute to these types of symptoms. But a big culprit can be intense use of your eyes. Spending too much time looking at screens and held devices, like smartphones, can strain your eyes. So can normal aging. What can you do to find relief?
One major cause of eye discomfort is not blinking enough. “When we focus on tasks like reading or computer work, our blink rate just plummets,” says Dr. Chantal Cousineau-Krieger, an NIH ophthalmologist.
Not blinking enough can cause your eyes to become dry and uncomfortable. Certain people are more prone to eye dryness, too. This includes those over age 50, women, and people who wear contact lenses. Certain medications, like antihistamines, and health conditions can also add to eye dryness.
Avoiding other factors that increase eye dryness may help your eyes feel better, too. Air blowing directly in your face from a fan or from air vents in the car can contribute to eye dryness, says Cousineau-Krieger. So can smoke or windy conditions.
Normal aging can also lead to eye strain. With age, we start to lose our ability to focus on close objects. This is called presbyopia. Our eyes need to work harder to focus.
“When we look at something up close, we flex the muscle inside of our eye,” Cousineau-Krieger explains. “And just like any other muscle, if you hold the contraction for a long time, the muscle can become fatigued. Eventually, in your 40s, you end up not being able to see things up close as well. It’s a natural part of aging that goes along with gray hairs and wrinkles. And then we typically need reading glasses to be able to see things up close.”
But eye strain doesn’t only happen to adults. Children can also develop symptoms from intensely using their eyes. They may not tell you that their eyes hurt. Instead, they may start blinking forcefully or rubbing their eyes.
Spending too much time on screens is also now believed to be contributing to children developing nearsightedness. Studies have shown growing rates of nearsightedness in children over the past few decades.
To relieve eye discomfort, you can try some simple steps. Experts recommend the 20-20-20 rule. Take eye breaks every 20 minutes and look far in the distance, about 20 feet away, for about 20 seconds.
“Experts are recommending that children spend time outdoors playing to help them focus on things further at a distance,” says Cousineau-Krieger. “Hopefully, this will also help decrease the amount of nearsightedness. The amount of nearsightedness is going up around the world.”
Taking screen breaks and focusing on more distant objects can be helpful for everyone’s eye health. See the Wise Choices box for more eye health tips. If simple lifestyle changes don’t bring you relief from eye discomfort, it may be time to see a doctor for an eye exam.
Migraine headaches can last for days. Some people have what’s called an aura before migraine pain sets in. Aura can include visual disturbances, such as seeing flashing lights. And it can include other sensory changes, like numbness or tingling.
Scientists have known that aura is caused by a disruption of electrical activity within the brain. But they hadn’t yet figured out how the aura might trigger pain. The nerve cells that drive migraine pain are known to sit outside the brain. And communication between these nerves and the brain was thought to be blocked by a structure called the blood-brain barrier.
To learn more, researchers looked at how spinal fluid flows out of the brains of mice. They found gaps in the blood-brain barrier around a bundle of nerve cells known to process migraine pain. Substances injected directly into the brain flowed into these nerve cells within half an hour. This time period is similar to the typical time between aura and headache.
The scientists next provoked migraine aura in the brains of mice. Then they measured changes in proteins that flowed into the nerve cells. They found changes in many proteins known to be involved in migraine headache. The results point to potential new ways to relieve migraine pain.
“These findings provide us with a host of new targets to prevent and treat migraines and strengthen existing therapies,” says Dr. Maiken Nedergaard of the University of Rochester, who helped lead the study.
