Anal fissure medication

Anal fissures facts

Anal fissures are cracks or tears in the anus and anal canal. They may be acute or chronic.

Anal fissures are caused primarily by trauma, but several non-traumatic diseases are associated with anal fissures and should be suspected if fissures occur in unusual locations.

The primary symptom of anal fissures is pain during and following bowel movements. Bleeding, itching, and a malodorous discharge also may occur.

Anal fissures are diagnosed and evaluated by visual inspection of the anus and anal canal. Endoscopy and, less commonly, gastrointestinal X-rays may be necessary.

Anal fissures are initially treated conservatively by adding bulk to the stool, softening the stool, consuming a high fiber diet, avoiding "sharp" or poorly digested foods, and utilizing sitz baths.
Ointments containing anesthetics, steroids, nitroglycerin, and calcium channel blocking drugs (CCBs) are used for treating anal fissures that fail to heal with less conservative management.

Injections of botulinum toxin may be effective when ointments are not effective. (The cost of treatment would be substantially reduced if the toxin were packaged in smaller doses.)
Surgery by lateral sphincterotomy is the gold standard for curing anal fissures. Because of complications, however, it is reserved for patients who are intolerant of non-surgical treatments or in whom non-surgical treatments have proven to be ineffective.

Medically Reviewed by a Doctor on 6/25/2014

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Headaches And Botox Injections

Headaches And Botox Injections
Headaches And Botox Injections

Most people are unaware that the use of Botox for the prevention of migraine headaches came about purely by accident. It all happened through the use of Botox by plastic surgeons. Patients undergoing plastic surgery, who were also experiencing headaches, noticed that their injections of Botox helped with their migraine headaches.

Botox, also known as botulinum toxin, is a neurotoxin (a toxin that attacks nerve cells). It was originally approved by the FDA for use in conditions where hyperactivity of muscles was an underlying problem of related health and medical conditions. The theory is that Botox weakens or paralyzes muscles by inhibiting the release of acetylcholine. Acetylcholine is an ester of choline that is thought to play an important role in the transmission of nerve impulses at synapses and myoneural (muscle-nerve) junctions. By inhibiting the release of acetylcholine the nerves cannot cause a muscle contraction, thus relaxing the muscle. Botox is administered by being directly injected into the affected muscles.

There are differing theories as to how Botox works to eliminate migraine headaches, but the exact reasoning remains unclear. One theory is that muscle tension and spasms are a cause of migraines and by eliminating the muscle tension with an injection of Botox it will also eliminate the cause of the headaches. If given Botox before the headache begins it is possible to eliminate the headache before it even starts.

When muscles spasm it can irritate nerves that innervate them. When these nerves send signals to the brain in an increased amount it causes pain and possibly headaches. Botox may affect these nerve cells, inhibiting their transmission, causing a lessening of the perception of pain. Many researches think that migraine headaches are a result of inflammation of blood vessels. However, muscle tension may also play an important role in the cause of headaches.

When researchers test a medication’s effectiveness they usually test it through a double-blind study. This means that some patients are given the medication being tested while others are given a placebo. A placebo is an inactive substance, such as sugar, that is given in place of the medication that is being evaluated. Some tests have been performed that did not involve double-blind studies, but showed that Botox could prevent migraine headaches. One double-blind study involving Botox and headaches showed only a small positive effect.

Initial studies may not have shown the full effectiveness of Botox for the prevention of headaches. The injections were not placed in the typical locations of the headache pain, but in areas normally injected during plastic surgery. In subsequent studies, using larger doses and injecting into more specific localities for the headache pain, the results were improved. These tests were concerning migraine headaches. However, with tension headaches, or muscle tension headaches, the studies have shown improved results. This is to be expected due to the weakening or paralyzing nature of Botox on the muscles that are experiencing tension.

When being injected with Botox for the prevention of headaches it may take several weeks before the injection takes effect. For this reason it is usually necessary to have it injected no more often than once every 3 months or so. People that have Botox administered for the treatment of headaches typically need it injected every few months. If there is too long of an interval between injections the headaches may be experienced by the patient.

However, the question arises about the safety of these regular injections of a neurotoxin. Since 1989, when it was first used as a headache treatment, it has appeared to be fairly safe. Most migraine headache medications are taken orally and eventually end up in the blood stream. Because of this common symptoms of migraine headache medication will be dizziness and drowsiness among other symptoms. Since Botox is injected directly into the muscle tissue and does not get absorbed into the blood system as does the typical headache medicine there are fewer side effects. Most commonly, the only side effects of injecting this neurotoxin is pain in the area of injection for a couple of days or drooping of the eyelids for a few days.

Studies are still being performed on this medication and as yet the FDA has not approved it for the treatment of headaches. However, physicians do prescribe it to their patients and if you think you are a candidate to use it you should discuss it with your doctor. If you do not respond to other headache medications it may be something to talk with your physician about. As the studies continue the effects and safety issues involving this medication should become more clear.

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Dangerous Drugs In The News

Dangerous Drugs In The News
Dangerous Drugs In The News

A number of “dangerous drugs” have been in the news recently. These reports started to surface when Congress was having hearings about the painkiller, Vioxx. A Food and Drug Administration staff member testified in front of Congress that there are safety concerns about several medications. These medications are Accutane, Arava, Bextra, Celebrex, Crestor, Lotronex, Meridia, and Serevent.

When you put the problems in perspective, the number of problems related to these medications is incredibly small compared to the number of people who took the drugs. If five million people have taken the medication and one has had a serious side effect, that’s one in a five million, or 0.00002%. The chances are not that great, but the chance is there.

The following is a quick summary of what the FDA believes are some of the concerns with these medications.

Accutane

This medication is very effective for severe acne. It is also well-known that Accutane causes serious birth defects. Because of this, the manufacturer has set guidelines for its dispensing. If the patient is female, she must have a negative pregnancy test EVERY month before the doctor writes the prescription. It then must be filled within seven days. The patient must also go back to the doctor every month for a new prescription. Women who take Accutane and are sexually active should two forms of birth control and not become pregnant for at least a month after stopping the medication.

The problems arise when women take Accutane from a friend or get it from another country. They are then not being monitored by a doctor and may not know the dangers of pregnancy.

Another topic surrounding Accutane is the reported increase in suicide rates. It has been stated that Accutane makes some patients feel depressed or irritable. This is where friends and family can step in and discuss these problems with the patient. If someone is feeling depressed or has thoughts of suicide while on Accutane, please tell them to let their doctor know right away.

Arava

Arava is used for treating severe rheumatoid arthritis. During the last several years, reports of serious lung or liver problems have arisen in patients taking this medication. Patients on Arava are required to get frequent liver function tests to detect any problems before they get serious. Virtually every time, liver failure occurs gradually over a long period of time. By testing frequently, these problems can be detected early and can be fixed. The signs of liver problems include: nausea, abdominal pain, fatigue, dark urine, pale stools, and yellowish eyes or skin.

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Insomnia Tips

Insomnia Tips
Insomnia Tips

Insomnia is a very common complaint among older adults. The condition affects more than 70 million Americans. Some symptoms include difficulty falling asleep, difficulty staying asleep, difficulty with early morning awakening, or not feeling rested by a “good night’s sleep.” Occasionally, insomnia lasts for a short time and can be easily managed. Other times it is a chronic condition, lasting more than six months. This chronic insomnia is more troublesome and can affect work, social relationships, and health. Many people with insomnia are also diagnosed with other conditions such as depression, anxiety, allergies, or pain.

Insomnia treatment begins with what is known as “sleep hygiene.” This includes regular sleep and wake times. You should avoid eating, drinking, or exercising before bedtime. The room should be cool, comfortable, and dark.

Philosophy of Sleep Hygiene

1. keep a regular sleep schedule

2. exercise regularly but avoid exercise before bed

3. go to bed when sleepy

4. do relaxing and enjoyable activities before bed

5. keep the bedroom quiet and comfortable

6. do not eat a large evening meal

7. if you are not sleeping within 20 minutes, get up and return to bed when you are sleepy

8. if you must take a nap, limit it to 30 minutes

9. avoid alcohol, caffeine, and nicotine

10. have your pharmacist check your medications for stimulating drugs

If the “sleep hygiene” methods are not working, then it may me necessary to begin using medication.

If you are still having difficulty getting a good night’s sleep, you should talk to your pharmacist or doctor. The cause of your insomnia will need to be determined and you may need medication to help you sleep. Even if medication is used for insomnia, “sleep hygiene” principles should still be followed and can provide added benefit.

The best medication should act quickly and for a short period of time. This eliminates the “hangover effect” some people experience.

There are many other products that might be used for insomnia. Melatonin has been shown to be helpful in treating insomnia due to melatonin deficiency in elderly patients. It may also improve sleep quality but probably will not increase the length of sleep time. Kava kava and valerian root are also commonly used for the treatment of insomnia. Kava kava has not been shown to be effective in the treatment of chronic insomnia. It is also known to be potentially dangerous to the liver. Valerian root may be helpful in helping one get to sleep as well as improving the quality of sleep.

There are a number of treatment options available for the treatment and management of insomnia. It is important to diagnose and attempt to treat the root or underlying cause first. After that, the practice known as “sleep hygiene” should be practiced. If “sleep hygiene” is not effective, then the use of prescription medication may be warranted.

The cheapest treatment is, of course, “sleep hygiene.” If you try this approach and are unsuccessful, I would recommend over-the-counter diphenhydramine, while still practicing “sleep hygiene.” There are many different types available. The next step would be to visit your doctor for a prescription. As is my usual recommendation, begin with the lowest priced medication.

For insomnia treatment, I would recommend trazodone first. Trazodone represents approximately 40% of all insomnia prescriptions. It is very cheap at less than $10 a month. If that is ineffective, go with temazepam. It is also very popular and cheap. It is, however, a controlled substance which means there is a possibility of addiction.

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Should You Take Prescription Medication For Anxiety Attacks

Should You Take Prescription Medication For Anxiety Attacks

Are you considering taking prescription medication to help “cure” the symptoms of your anxiety attacks? Let’s face it, we’ve all the seen the commercials from the various drug companies promising a simple “cure” for your anxiety attacks by taking prescription medication.

Here’s what they don’t tell you:

1. Prescription medications mask the root problem of your anxiety attacks. Yes, you may have temporary relief of your symptoms but your anxiety attacks started for a reason. You need to discover the root problem in order to find the solution as to why your body is reacting with an anxiety attack instead of covering it up with medication.

2. Prescription medications are addictive, which can mean a long, agonizing withdrawal period when you want to get off them. You have to wean yourself off gradually and this process can cause your anxiety attack symptoms to worsen or other side affects to occur before you are completely off the prescription medication.

3. After long-term use of the prescription medication, you may find that you need higher doses in order to keep the medication functioning. You may end up returning to your doctor repeatedly, only to have him increase your dosage, or worse, prescribe a stronger medication for you.

The remarkable part about these drug prescription commercials is the disclaimer they ramble off quickly near the end listing the side affects that some of these prescription drugs can produce. Are you truly prepared to risk your long-term health by taking these prescription medications?

The commercials make the “cure” sound so wonderful: take a pill and all your anxiety attack symptoms will be gone. It’s very tempting to be seduced into a quick-fix. However, you should take a pro-active approach and do further research before you buy into these so-called “cures”. There is massive information available on the internet about anxiety disorders as well as on specific prescription drugs and their side-effects.

You should know that natural remedies do exist such as Chamomile tea or St. John’s Wort for relief of some anxiety attack symptoms. Moreover, you may find that an appointment with a Naturopathic doctor or a Hypno-Therapist to be a more natural solution than a visit to your family physician and his trust prescription pad.

Be an informed anxiety attack patient. Do your research and find the natural cure that will work for you over the long term without the harmful side-effects. Anxiety attacks are 100% curable; you only need to find the natural solution that is right for you.

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