Really really bad bloating issues - advice needed!

I am a 15 year old girl suffering from anorexia, height 166 cm  and weight 39 kg. Yesterday I severely restricted because I thought I had binged the day before, and today I have eaten quite a bit more than usual. I have really really bad bloating and indigestion, I am badly constipated and my chest hurts. Is this due to the fact that I restricted and then started eating normally again??

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Urologists' Group Issues Updated Guidelines on PSA Test

FRIDAY, May 3 (HealthDay News) -- New guidelines from the nation's leading group of urologists on the controversial PSA test for prostate cancer highlight the importance of discussions between a man and his doctor.

Especially for men in their late 50s and 60s, the usefulness of the blood test may have to be decided on a case-by-case basis, according to new recommendations from the American Urological Association (AUA).

One expert called the new guidelines "a paradigm shift" in prostate cancer detection.

Dr. Louis Potter, chairman of radiation medicine at North Shore-LIJ Health System in New Hyde Park, N.Y., said the recommendations mark a move to more "personalized health management, where risk and age are balanced against the value of screening."

Prostate-specific antigen (PSA) screening is a test that measures the level of a key marker for prostate cancer in the blood. In general, the higher the level of this protein, the more likely it is that a man has prostate cancer, according to the U.S. National Cancer Institute.

The value of the PSA test has recently come into question, however, with several studies suggesting it causes men more harm than good -- spotting too many slow-growing tumors that, especially in older patients, may never lead to serious illness or death. In 2012, the U.S. Preventive Services Task Force, an influential government-appointed panel, advised against the routine use of the PSA test for prostate cancer.

The new AUA guidelines are more nuanced. The group does recommend against the PSA test for men under age 40 or for those aged 40 to 54 at average risk for prostate cancer.

The AUA says, however, that men aged 55 to 69 should talk to their doctors about the risks and benefits of PSA screening and make a decision based on their personal values and preferences.

Routine PSA screening is not recommended for men over age 70 or any man with less than a 10- to 15-year life expectancy.

The best evidence of benefit from PSA screening was among men aged 55 to 69 screened every two to four years. In this group, PSA testing was found to prevent one death a decade for every 1,000 men screened. But this benefit could be much greater over a lifetime, the guidelines noted.

The guidelines also said PSA screening could benefit men in other age groups who are at higher risk of prostate cancer due to factors such as race and family history. These men should discuss their risk with a doctor and assess the benefits and potential harms of PSA testing.

The new guideline updates the AUA's 2009 Best Practice Statement on Prostate-Specific Antigen and was announced at the association's annual meeting in San Diego on Friday.

"There is general agreement that early detection, including prostate-specific antigen screening, has played a part in decreasing mortality from prostate cancer," Dr. H. Ballentine Carter, who chaired the panel that developed the guidelines, said in an AUA news release.

There is more and better data about PSA screening available today than there was in 2009, so it is "time to reflect on how we screen men for prostate cancer and take a more selective approach in order to maximize benefit and minimize harms," Carter said.

One expert said the revised guidelines made sense.

"I think these guidelines are quite appropriate given the [slow-growing] nature of many prostate cancers," said Dr. Erik Goluboff, an attending urologist in the department of urologic oncology at Beth Israel Medical Center in New York City.

He agreed that discussions between a patient and his doctor on the PSA test are "extremely important."

"It has become increasingly evident that many, if not most, men diagnosed with early prostate cancer will never need treatment and can be spared the potentially devastating side effects of treatment such as urinary incontinence and erectile dysfunction," Goluboff said.

Some men, including black patients and patients with a family history of prostate cancer, may still decide to undergo PSA testing, he added. "This is in contrast to the U.S. Preventive Services Task Force, where a blanket statement that PSA screening is bad, regardless of individual patient risk, was made," Goluboff said.

A better test that pinpoints aggressive, life-threatening prostate tumors might be developed in the future, to better guide patients. "Hopefully, with discovery of better tumor markers, aggressive prostate cancers can be distinguished from [slow-growing] ones and only patients who need to will receive treatment," Goluboff said.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCES: Louis Potters, M.D, chair, radiation medicine, North Shore - LIJ Health System, New Hyde Park, NY; Erik Goluboff, M.D., attending urologist, department of urologic oncology, Beth Israel Medical Center, New York City; American Urological Association, news release, May 3, 2013

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Health Tip: Don't Ignore Pacemaker Issues

(HealthDay News) -- If you have an irregular heartbeat, a pacemaker can help restore your heart to its natural rhythm and help the heart continue to pump blood to the rest of the body.

But once the device is implanted, you shouldn't just "set it and forget it," experts say. The National Heart Lung and Blood Institute says these potential problems can affect a pacemaker:

Interference with the pacemaker's electrical signal caused by other devices, such as cellphones, microwave ovens or high-tension electrical wiring.Broken or dislodged wires.Failing or weakened battery.Progression of heart disease.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

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Bowel Issues Affect 3 Out of 4 Pregnant Women

These problems don't significantly affect quality of life, study says

By Mary Elizabeth Dallas

HealthDay Reporter

FRIDAY, May 24 (HealthDay News) -- Nearly three out of four pregnant women experience bowel problems such as constipation and diarrhea, but these issues don't significantly affect their quality of life, a new study finds.

Researchers from Loyola University Medical Center in Maywood, Ill., noted that these bowel issues are due to physiological and hormonal changes that occur during pregnancy. Nutritional supplements that women take during pregnancy also can play a role. The study authors added that since women expect these problems to arise during pregnancy, they're better able to tolerate them.

The study included 104 women in their first trimester of pregnancy and 66 women in their third trimester. They completed two questionnaires: one asking about the bowel disorders they experienced and another on how these problems affected their quality of life. Specifically, the women were asked if their bowel issues made life less enjoyable, limited what they could wear or eat, or made them feel embarrassed, vulnerable, angry, isolated or depressed.

The study revealed that 72 percent of the first-trimester respondents and 61 percent of the third-trimester respondents had one or more bowel disorders, including constipation, diarrhea, bloating and irritable bowel syndrome.

On a scale of one to 100, with 100 being the least impact on quality of life, the women's average score was 94.9. The researchers said two issues had a measurable effect on quality of life: Both constipation and bloating reduced the quality-of-life score by approximately four points.

Study senior author Dr. Scott Graziano, associate professor of obstetrics and gynecology at the Loyola University Chicago Stritch School of Medicine, advises pregnant women to drink plenty of fluids and consume 25 to 30 grams of fiber daily. The study found that pregnant women consume only 16 to 17 grams of fiber a day. Stool softeners and suppositories are safe for pregnant women, Graziano said.

The study's findings were presented earlier this month at the American College of Obstetricians and Gynecologists' annual meeting in New Orleans. Data and conclusions from studies presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

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Pediatrics Group Issues New Ear Infection Guidelines

By Serena Gordon

HealthDay Reporter

MONDAY, Feb. 25 (HealthDay News) -- The American Academy of Pediatrics has issued new guidelines for identifying and treating a common childhood ailment that can cause a lot of misery -- the ear infection.

In the guidelines released Monday, the pediatrics group more clearly defines the signs and symptoms that indicate an infection that might need treatment. They also encourage observation with close follow-up instead of antibiotic treatment for many children, including some under the age of 2 years. And, for parents of children with recurrent infections, the new guidelines advise physicians and parents when it's time to see a specialist.

"Between a more accurate diagnosis and the use of observation, we think we can greatly decrease the use of antibiotics," said the lead author of the new guidelines, Dr. Allan Lieberthal, a pediatrician at Kaiser Permanente Panorama City, in Los Angeles, and a clinical professor of pediatrics at the Keck School of Medicine at the University of Southern California.

The last set of guidelines was issued in 2004. Lieberthal said those stimulated a lot of new research, which provided additional evidence for the current American Academy of Pediatrics (AAP) guidelines appearing in the March issue of Pediatrics.

Lieberthal said the biggest change in the new document is the definition of the diagnosis itself.

Pediatrician Dr. Roya Samuels, who has reviewed the new guidelines, agreed. "The definition is more clear-cut, more precise," she said. But, she added, "There's still no gold standard for diagnosis. There are different stages of [ear infections], and making the diagnosis can be tricky."

Because the diagnosis isn't always easy to make, the AAP offers detailed treatment suggestions, encouraging observation with close follow-up, but also leaves it up to the discretion of the doctor whether or not to prescribe antibiotics. If children who are being observed don't improve within 48 to 72 hours from when symptoms first began, the guidelines recommend beginning antibiotic therapy.

Previous guidelines recommended giving antibiotics for ear infections in children age 2 and under. The new guidelines suggest that children aged between 6 months and 23 months can be observed with close follow-up as long as they don't have severe symptoms.

Another key component of the new guidelines is pain management. "Antibiotics take 24 to 48 hours before they start to improve signs and symptoms, so if a child has fever or pain, it's important to place them on [pain-relieving or fever-reducing medications]," Samuels said.

The guidelines also confirm that amoxicillin should be the antibiotic of choice unless the child is allergic to penicillin, or if the child has been treated with amoxicillin during the past month.

The new guidance from the AAP also states that children, even those with recurrent infections, shouldn't be on long-term daily antibiotics to try to prevent infections from occurring.

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Don't Overlook Eating Issues Tied to Autism, Study Warns

By Robert Preidt

HealthDay Reporter

SATURDAY, Feb. 9 (HealthDay News) -- Children with autism are five times more likely than other kids to have feeding issues, such as being especially picky eaters or having ritualistic behaviors or extreme tantrums during meals, new research finds.

These problems can lead to deficiencies in calcium, protein and other nutrients, according to the study, which was published online this month in the Journal of Autism and Developmental Disorders.

Healthy eating promotes a child's growth and development, and mealtimes provide important opportunities for children to socialize, the researchers noted. Chronic feeding troubles increase a child's risk for problems such as malnutrition, poor growth, social difficulties and poor school performance.

The researchers added that there is growing evidence that feeding problems and dietary patterns among children with autism may put them at increased risk for long-term health problems such as poor bone growth, obesity and cardiovascular disease.

"The results of this study have broad implications for children with autism," study author William Sharp, an assistant professor at Emory University School of Medicine in Atlanta, said in a university news release.

"It not only highlights the importance of assessing mealtime concerns as part of routine health care screenings, but also suggests the need for greater focus on diet and nutrition in the autism community," added Sharp, who also is a behavioral pediatric psychologist in the Pediatric Feeding Disorders Program at Marcus Autism Center in Atlanta.

Sharp said that despite the risk of long-term medical issues, feeding problems often are overlooked in relation to other areas of concern in the autism population.

"Our findings have immediate and important implications for the work of practitioners serving children and families with autism, who in the absence of such information may struggle to address parents' concerns, or, worse, may fill the void with alternative treatments that may be ill-conceived or even harmful to children and families," Sharp explained.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about autism.

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Exposure to light at night may cause depression, learning issues, mouse study suggests

Nov. 14, 2012 — For most of history, humans rose with the sun and slept when it set. Enter Thomas Edison and colleagues, and with a flick of a switch, night became day, enabling us to work, play and post cat and kid photos on Facebook into the wee hours.

Share This:See Also:Health & MedicineMental Health ResearchVitamin DMind & BrainDepressionEducational PsychologyPlants & AnimalsMiceRodentsLiving WellReferenceSeasonal affective disorderSleep deprivationPupillary reflexCircadian rhythm sleep disorder

According to a new study of mice led by a Johns Hopkins biologist, however, this typical 21st-century scenario may come at a serious cost: When people routinely burn the midnight oil, they risk suffering depression and learning issues, and not only because of lack of sleep. The culprit could also be exposure to bright light at night from lamps, computers and even iPads.

"Basically, what we found is that chronic exposure to bright light -- even the kind of light you experience in your own living room at home or in the workplace at night if you are a shift worker -- elevates levels of a certain stress hormone in the body, which results in depression and lowers cognitive function," said Samer Hattar, a biology professor in the Johns Hopkins University's Krieger School of Arts and Sciences.

Published in the Nov. 14 advance online publication of the journal Nature, the mice study demonstrates how special cells in the eye (called intrinsically photosensitive retinal ganglion cells, or ipRGCs) are activated by bright light, affecting the brain's center for mood, memory and learning.

But the study involved mice, so why are we talking about humans? Hattar offers some insight: "Mice and humans are actually very much alike in many ways, and one is that they have these ipRGCs in their eyes, which affect them the same way," he said. "In addition, in this study, we make reference to previous studies on humans, which show that light does, indeed, impact the human brain's limbic system. And the same pathways are in place in mice."

The scientists knew that shorter days in the winter cause some people to develop a form of depression known as "seasonal affective disorder" and that some patients with this mood disorder benefit from "light therapy," which is simple, regular exposure to bright light.

Hattar's team, led by graduate students Tara LeGates and Cara Altimus, posited that mice would react the same way, and tested their theory by exposing laboratory rodents to a cycle consisting of 3.5 hours of light and then 3.5 hours of darkness. Previous studies using this cycle showed that it did not disrupt the mice's sleep cycles, but Hattar's team found that it did cause the animals to develop depression-like behaviors.

"Of course, you can't ask mice how they feel, but we did see an increase in depression-like behaviors, including a lack of interest in sugar or pleasure seeking, and the study mice moved around far less during some of the tests we did," he said. "They also clearly did not learn as quickly or remember tasks as well. They were not as interested in novel objects as were mice on a regular light-darkness cycle schedule."

The animals also had increased levels of cortisol, a stress hormone that has been linked in numerous previous studies with learning issues. Treatment with Prozac, a commonly prescribed anti-depressant, mitigated the symptoms, restoring the mice to their previous healthy moods and levels of learning, and bolstering the evidence that their learning issues were caused by depression.

According to Hattar, the results indicate that humans should be wary of the kind of prolonged, regular exposure to bright light at night that is routine in our lives, because it may be having a negative effect on our mood and ability to learn.

"I'm not saying we have to sit in complete darkness at night, but I do recommend that we should switch on fewer lamps, and stick to less-intense light bulbs: Basically, only use what you need to see. That won't likely be enough to activate those ipRGCs that affect mood," he advises.

This study was supported by a grant from the David and Lucile Packard Foundation.

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