7 causes, symptoms, and treatments

Body aches and diarrhea are symptoms of a condition, rather than conditions in themselves.

Body aches

Body aches may affect a specific area of the body or the entire body. The pain and discomfort from these aches can range from mild to severe.

Depending on the cause, body aches may be either sudden and temporary or long lasting. Doctors refer to these as acute and chronic, respectively.

Diarrhea

The term diarrhea refers to the passing of loose, watery stools three or more times per day.

Other symptoms may accompany diarrhea, including:

• an urgent need to use the bathroom
• an inability to control bowel movements
• stomach pain and cramping
• nausea

If diarrhea results from an infection, people may also experience:

Below are some of the possible causes of body aches with diarrhea.

1. Food poisoning

Food poisoning can occur when a person consumes food or drink that contains harmful pathogens, such as bacteria or viruses. Many different pathogens can cause food poisoning, including:

The pathogens responsible for food poisoning can come from the following sources:

• undercooked meats
• unpasteurized milk
• improperly washed fruits or vegetables

The symptoms of food poisoning can differ depending on the pathogen responsible. However, some general symptoms include:

• stomach cramps
• diarrhea
• nausea and vomiting
• fever
• muscle aches

The symptoms may develop 30 minutes to 4 weeks after consuming contaminated food or drink. The length of time it takes to develop symptoms depends on the pathogen responsible.

Treatment

The symptoms of food poisoning typically go away without the need for medical treatment. In the meantime, people can try the following:

• drinking plenty of fluids to replace water and electrolytes lost during bouts of vomiting or diarrhea
• taking over-the-counter (OTC) medications, such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol), to help alleviate diarrhea in adults
• eating plain foods, such as crackers
• using oral rehydration solutions, for people with a weakened immune system and children (only after checking with a doctor)

If a person needs medical treatment, a doctor will first have to establish whether the food poisoning is due to a bacterium, parasite, or virus. If bacteria or parasites are responsible, the doctor may prescribe antibiotics.

A doctor may also prescribe or recommend OTC probiotics to help reduce the duration of diarrhea.

2. Viral gastroenteritis

Viral gastroenteritis (VG) is the medical term for a viral infection of the intestines. People can catch such viruses as a result of coming into contact with the stool or vomit of a person who has the infection.

Symptoms of VG include:

Treatment

People who have VG can use OTC medications, such as Imodium and Pepto-Bismol, to treat diarrhea. They should also make sure that they replace any lost fluids and electrolytes to prevent dehydration.

3. Influenza

Influenza, or flu, viruses are a group of viruses that can cause seasonal flu. They are highly contagious. People can contract them by inhaling droplets from the coughs or sneezes of a person with the virus. They can also get the virus if they come into contact with infected droplets on inanimate objects, such as doorknobs or computer keyboards, and then touch their eyes, nose, or mouth.

Some symptoms of the flu include:

• cough
• sore throat
• runny or stuffy nose
• fever
• body aches and headaches
• occasionally, diarrhea and vomiting (more common in children)

Treatment

In most cases, the flu will go away on its own without the need for medical treatment. However, people can take OTC nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen to help alleviate some of the symptoms.

If a person is experiencing severe flu symptoms, a doctor may prescribe antiviral medication.

Doctors also recommend that people get a flu vaccination before the start of the flu season each year to reduce the chance of developing the flu.

4. Lactose intolerance

Lactose intolerance is a digestive disorder in which the body is unable to break down and digest lactose. Lactose is a naturally occurring sugar present in milk and dairy products.

The symptoms of lactose intolerance include:

• bloating
• gas or flatulence
• diarrhea
• nausea and vomiting
• stomach cramping and discomfort
• painful or aching muscles or joints

Treatment

The main treatment for lactose intolerance is to limit or avoid foods and drinks that contain lactose. Some people may be able to consume small amounts of these foods, whereas others will not be able to consume any.

People can also try taking lactase tablets or drops immediately before consuming foods or drinks containing lactose. Lactase is an enzyme that breaks down lactose, thereby preventing the symptoms of lactose intolerance. However, lactase products are not suitable for young children or people who are pregnant or breastfeeding.

5. Gluten sensitivity

Gluten sensitivity is a condition in which a person experiences symptoms in response to eating foods containing gluten. Examples of such foods include:

Common symptoms of gluten sensitivity include:

• bloating or gas
• diarrhea or constipation
• stomach pain
• nausea
• headaches
• joint pain
• numbness in the legs, arms, or fingers
• brain fog
• fatigue

Treatment

A person who experiences symptoms after eating foods containing gluten should see their doctor, who will need to rule out more serious conditions, such as celiac disease.

A person should not try a gluten-free diet until they have had a blood test for celiac disease. Following such a diet could reduce the accuracy of the test.

If tests confirm that a person does have gluten sensitivity, their doctor will recommend cutting gluten out of the diet to prevent symptom flare-ups.

6. Celiac disease

Celiac disease is an autoimmune disorder in which the body cannot process gluten. It is similar to gluten sensitivity but more severe. In people with celiac disease, the consumption of gluten causes the immune system to attack and destroy healthy cells in the small intestine.

The symptoms of celiac disease include:

• bloating and gas
• stomach aches and pain
• nausea and vomiting
• diarrhea or constipation
• pale, foul-smelling stools that float

Treatment

The main treatment for celiac disease is to eat a gluten-free diet. A doctor may refer a person to a dietitian who specializes in devising nutritious, gluten-free meal plans.

People with celiac disease should also take steps to limit their exposure to gluten in other ways. For instance, they can check with a pharmacist whether medications or supplements contain gluten before taking them. They can also read labels on cosmetics and household items to ensure that they do not contain gluten.

7. Irritable bowel syndrome

Irritable bowel syndrome (IBS) is the collective term for a group of symptoms that affect the digestive system. According to the National Institute of Diabetes and Digestive and Kidney Diseases, IBS is a functional gastrointestinal disorder. This definition means that it is the result of the brain and gut not working together as they should.

There are three different types of IBS:

• IBS with constipation
• IBS with diarrhea
• IBS with mixed bowel habits

Symptoms of IBS include:

• stomach pain and aches
• bloating
• diarrhea, constipation, or both
• white mucus in stools

Treatment

People may be able to reduce the symptoms of IBS by making the following changes to their diet:

Using techniques to manage stress, such as meditation, mindfulness, and yoga, can also be beneficial.

If a person has IBS with diarrhea, a doctor may prescribe medications such as Imodium or rifaximin (Xifaxan) to treat the diarrhea.

Doctors may also prescribe antispasmodics to help treat stomach pain and cramping.

7 causes, symptoms, and treatments

Body aches and diarrhea are symptoms of a condition, rather than conditions in themselves.

Body aches

Body aches may affect a specific area of the body or the entire body. The pain and discomfort from these aches can range from mild to severe.

Depending on the cause, body aches may be either sudden and temporary or long lasting. Doctors refer to these as acute and chronic, respectively.

Diarrhea

The term diarrhea refers to the passing of loose, watery stools three or more times per day.

Other symptoms may accompany diarrhea, including:

• an urgent need to use the bathroom
• an inability to control bowel movements
• stomach pain and cramping
• nausea

If diarrhea results from an infection, people may also experience:

Below are some of the possible causes of body aches with diarrhea.

1. Food poisoning

Food poisoning can occur when a person consumes food or drink that contains harmful pathogens, such as bacteria or viruses. Many different pathogens can cause food poisoning, including:

The pathogens responsible for food poisoning can come from the following sources:

• undercooked meats
• unpasteurized milk
• improperly washed fruits or vegetables

The symptoms of food poisoning can differ depending on the pathogen responsible. However, some general symptoms include:

• stomach cramps
• diarrhea
• nausea and vomiting
• fever
• muscle aches

The symptoms may develop 30 minutes to 4 weeks after consuming contaminated food or drink. The length of time it takes to develop symptoms depends on the pathogen responsible.

Treatment

The symptoms of food poisoning typically go away without the need for medical treatment. In the meantime, people can try the following:

• drinking plenty of fluids to replace water and electrolytes lost during bouts of vomiting or diarrhea
• taking over-the-counter (OTC) medications, such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol), to help alleviate diarrhea in adults
• eating plain foods, such as crackers
• using oral rehydration solutions, for people with a weakened immune system and children (only after checking with a doctor)

If a person needs medical treatment, a doctor will first have to establish whether the food poisoning is due to a bacterium, parasite, or virus. If bacteria or parasites are responsible, the doctor may prescribe antibiotics.

A doctor may also prescribe or recommend OTC probiotics to help reduce the duration of diarrhea.

2. Viral gastroenteritis

Viral gastroenteritis (VG) is the medical term for a viral infection of the intestines. People can catch such viruses as a result of coming into contact with the stool or vomit of a person who has the infection.

Symptoms of VG include:

Treatment

People who have VG can use OTC medications, such as Imodium and Pepto-Bismol, to treat diarrhea. They should also make sure that they replace any lost fluids and electrolytes to prevent dehydration.

3. Influenza

Influenza, or flu, viruses are a group of viruses that can cause seasonal flu. They are highly contagious. People can contract them by inhaling droplets from the coughs or sneezes of a person with the virus. They can also get the virus if they come into contact with infected droplets on inanimate objects, such as doorknobs or computer keyboards, and then touch their eyes, nose, or mouth.

Some symptoms of the flu include:

• cough
• sore throat
• runny or stuffy nose
• fever
• body aches and headaches
• occasionally, diarrhea and vomiting (more common in children)

Treatment

In most cases, the flu will go away on its own without the need for medical treatment. However, people can take OTC nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen to help alleviate some of the symptoms.

If a person is experiencing severe flu symptoms, a doctor may prescribe antiviral medication.

Doctors also recommend that people get a flu vaccination before the start of the flu season each year to reduce the chance of developing the flu.

4. Lactose intolerance

Lactose intolerance is a digestive disorder in which the body is unable to break down and digest lactose. Lactose is a naturally occurring sugar present in milk and dairy products.

The symptoms of lactose intolerance include:

• bloating
• gas or flatulence
• diarrhea
• nausea and vomiting
• stomach cramping and discomfort
• painful or aching muscles or joints

Treatment

The main treatment for lactose intolerance is to limit or avoid foods and drinks that contain lactose. Some people may be able to consume small amounts of these foods, whereas others will not be able to consume any.

People can also try taking lactase tablets or drops immediately before consuming foods or drinks containing lactose. Lactase is an enzyme that breaks down lactose, thereby preventing the symptoms of lactose intolerance. However, lactase products are not suitable for young children or people who are pregnant or breastfeeding.

5. Gluten sensitivity

Gluten sensitivity is a condition in which a person experiences symptoms in response to eating foods containing gluten. Examples of such foods include:

Common symptoms of gluten sensitivity include:

• bloating or gas
• diarrhea or constipation
• stomach pain
• nausea
• headaches
• joint pain
• numbness in the legs, arms, or fingers
• brain fog
• fatigue

Treatment

A person who experiences symptoms after eating foods containing gluten should see their doctor, who will need to rule out more serious conditions, such as celiac disease.

A person should not try a gluten-free diet until they have had a blood test for celiac disease. Following such a diet could reduce the accuracy of the test.

If tests confirm that a person does have gluten sensitivity, their doctor will recommend cutting gluten out of the diet to prevent symptom flare-ups.

6. Celiac disease

Celiac disease is an autoimmune disorder in which the body cannot process gluten. It is similar to gluten sensitivity but more severe. In people with celiac disease, the consumption of gluten causes the immune system to attack and destroy healthy cells in the small intestine.

The symptoms of celiac disease include:

• bloating and gas
• stomach aches and pain
• nausea and vomiting
• diarrhea or constipation
• pale, foul-smelling stools that float

Treatment

The main treatment for celiac disease is to eat a gluten-free diet. A doctor may refer a person to a dietitian who specializes in devising nutritious, gluten-free meal plans.

People with celiac disease should also take steps to limit their exposure to gluten in other ways. For instance, they can check with a pharmacist whether medications or supplements contain gluten before taking them. They can also read labels on cosmetics and household items to ensure that they do not contain gluten.

7. Irritable bowel syndrome

Irritable bowel syndrome (IBS) is the collective term for a group of symptoms that affect the digestive system. According to the National Institute of Diabetes and Digestive and Kidney Diseases, IBS is a functional gastrointestinal disorder. This definition means that it is the result of the brain and gut not working together as they should.

There are three different types of IBS:

• IBS with constipation
• IBS with diarrhea
• IBS with mixed bowel habits

Symptoms of IBS include:

• stomach pain and aches
• bloating
• diarrhea, constipation, or both
• white mucus in stools

Treatment

People may be able to reduce the symptoms of IBS by making the following changes to their diet:

Using techniques to manage stress, such as meditation, mindfulness, and yoga, can also be beneficial.

If a person has IBS with diarrhea, a doctor may prescribe medications such as Imodium or rifaximin (Xifaxan) to treat the diarrhea.

Doctors may also prescribe antispasmodics to help treat stomach pain and cramping.

Feeling Sick? Use this Symptom Checker for Common Fall and Winter Illnesses

As the weather cools, viruses have a tendency to spread with more ease. That’s because people tend to spend more time indoors, where germs can circulate from one person to another through the air or close contact. This fall or winter, if you find yourself sniffling and sneezing, or experiencing an upset stomach, you could have a common virus.

We’ve created a symptom checker to help you tell the difference between cold and flu symptoms, COVID-19 symptoms and norovirus symptoms. Read on to learn more, and remember to always call your doctor if you have any concerns about your health.

Cold

What is it?

A cold is a respiratory illness caused by different types of viruses, with rhinoviruses being the most common. Colds frequently circulate in winter and spring, but a person can become ill with a cold any time of the year.

What are cold symptoms?

Cold symptoms can be similar to flu symptoms, but they’re generally milder, and usually include the following:

• Runny nose
• Sore throat
• Headache
• Body aches
• Coughing
• Sneezing

How long do cold symptoms last?

Most people recover from a cold within seven to 10 days.

When should you see a doctor about your cold symptoms?

If you experience any of the following, you may want to consider calling a health care professional:

• A fever lasting longer than four days, or, in babies younger than three months, a fever that is 100.4 or higher
• Symptoms that lasts 10 days or more with no improvement
• Fever, cough or other symptoms that improve but then return or become more severe
• Dehydration
• Difficulty breathing or rapid breathing
• Chronic health conditions that worsen
• Any other symptoms that cause you concern

Influenza

What is it?

The flu, also known influenza, is a respiratory illness caused by different viruses. The flu can be mild or severe, and even lead to hospitalization or death. Certain groups of people, including young children, pregnant women, older adults and people with underlying health conditions may be at risk for serious complications. An annual flu vaccine can help prevent getting sick. The CDC recommends, with few exceptions, that everyone six months and older get a flu vaccine at the start of every flu season, ideally in September or October.

What are influenza symptoms?

Flu symptoms can be similar to cold symptoms, but they’re generally more severe; they can also be similar to COVID-19 symptoms. Common flu symptoms include:

• Fever
• Sore throat
• Cough
• Headache
• Runny/stuffy nose
• Muscle/body aches
• Fatigue
• Vomiting/diarrhea (more common in children)

How long do influenza symptoms last?

Some people with the flu will recover in a few days, while others may take closer to two weeks. If complications arise, recovery could take longer and require medical assistance.

When should you see a doctor about influenza symptoms?

There are many types of flu symptoms that demand medical attention, and while the following list includes a number of them, it’s not conclusive. Always call your doctor if you’re concerned about a symptom such as:

• Fast breathing/trouble breathing
• Chest pain/pressure
• Severe muscle pain
• Dehydration/not urinating
• Not alert/interaction when awake; confused; dizzy
• Seizures
• Severe weakness
• Fever or cough that improves but then return/worsens
• Chronic medical conditions that worsen

COVID-19

What is COVID-19?

COVID-19, which is a new type of coronavirus, is a respiratory illness that can impact people in different ways, with some people experiencing symptoms similar to the flu. Like the flu, COVID-19 symptoms can range from mild to severe, and older adults and people with underlying health conditions may be at greater risk of developing serious complications. Unlike the flu, there is not yet a vaccine for COVID-19.

What are COVID-19 symptoms?

Health care professionals are still learning about COVID-19. The following list includes a number of potential symptoms, but not all symptoms. Call your health care provider if you think you might have COVID-19 and arrange to get tested.

• Fever/chills
• Cough
• Shortness of breath/difficulty breathing
• Muscle/body aches
• Fatigue
• Headache
• Loss of taste or smell
• Sore throat
• Runny/stuffy nose
• Nausea, vomiting and diarrhea

How long do COVID-19 symptoms last?

Mild cases tend to last one to two weeks, while more severe cases can last six weeks or more, and cause lasting damage.

When should you see a doctor about COVID-19 symptoms?

COVID-19 can lead to serious complications and even death. Call for help immediately if experiencing the following symptoms:

• Difficulty breathing
• Ongoing pain/pressure in the chest
• A sense of confusion
• Trouble staying awake or waking up
• Blue tint to the lips or face

Norovirus

What is norovirus?

Norovirus, sometimes referred to as a stomach bug or stomach flu, is a virus that can spread through contaminated foods and water, or contact with an infected person. It is one of the leading causes of acute gastroenteritis, and is the top cause of foodborne illness. Norovirus can strike at any time of year, but is most common November to April.

What are norovirus symptoms?

If you think you may have the stomach flu or a stomach bug, it could be norovirus. Common symptoms include:

How long do norovirus symptoms last?

A person usually develops symptoms 12 to 48 hours after being exposed to norovirus. Generally, people with norovirus recover in one to three days.

When should you call a doctor about norovirus symptoms?

You should call a doctor if you have any of the following:

• Bloody stool
• Severe vomiting
• Stomach pain
• Dehydration
• Diarrhea that continues after several days

In recent months, COVID-19 has highlighted the importance of frequent handwashing and social distancing to help stop the spread of disease. This fall and winter, remember those lessons, and more: get your flu vaccinations, find ways to manage stress, stay active, prepare food safely and see your health care provider for regular exams and screenings. With the proper precautions, you can strive to head into 2021 healthy and ready for a new beginning.

COVID-19: Signs, Symptoms, and Complications

COVID-19 is the disease caused by a SARS-CoV-2 infection. People who have COVID-19 can experience a range of symptoms and illness intensity from mild to severe. Or they may have no symptoms at all.

The most common symptoms include fever or chills, cough, shortness of breath, fatigue, body aches, headache, sore throat, a loss of taste or sense of smell, a stuffy or runny nose, and gastrointestinal symptoms. In children, the most common COVID-19 symptoms are fever and cough. However, children can experience any of the same symptoms as adults.

Frequent Symptoms 

Although people with COVID-19 may have many symptoms, the Centers for Disease Control and Prevention (CDC) lists 11 of the most common. Symptoms typically appear between 2 and 14 days after infection:

• Fever or chills
• Cough
• Shortness of breath
• Fatigue 
• Muscle and body aches
• Headache 
• Loss of taste or smell
• Sore throat
• Congestion or runny nose 
• Nausea or vomiting
• Diarrhea

Fever or Chills

Fever is often one of the first symptoms to develop after a SARS-CoV-2 infection, according to research published in Frontiers in Public Health. Not everyone with COVID-19 will develop a fever or body chills, and, in some cases, a fever may be low-grade. A fever is typically defined as a temperature of 100.4 degrees F or above. Chills are often a symptom of fever.

Cough

A cough is one of the most common signs of COVID-19. However, not everyone who is infected with the coronavirus will develop a cough, which can also be a sign of another respiratory illness or condition like the flu. Often, in COVID-19, a cough follows the start of a fever.

Shortness of Breath

Shortness of breath is another common symptom of COVID-19. Difficulty breathing is an emergency warning sign and requires immediate medical attention.

Fatigue 

Intense fatigue is a symptom often reported by people who have tested positive for COVID-19, and it’s one that often persists after other symptoms like fever are resolved, according to research published in JAMA. 

Muscle and Body Aches 

If you have COVID-19, you may also experience muscle pain, joint pain, or all-over body aches as a result of inflammation. However, body aches can also be a sign of influenza. In symptom progression in COVID-19, often muscle or body aches begin after the start of a fever and cough.

Headache

A headache is another common symptom of COVID-19, especially in conjunction with other symptoms, such as a fever, cough, or body aches.

Loss of Taste or Smell 

A loss of taste or smell is prevalent among people who test positive for COVID-19. The CDC reports that this symptom is not generally characteristic of the flu.

Sore Throat 

While a sore throat can be a symptom of other respiratory infections or even post-nasal drip, it is also a common symptom of COVID-19.

Congestion or Runny Nose 

A stuffy or runny nose can be a symptom of allergies, the common cold, the flu, and other conditions, but it is also a frequent complaint among individuals who have tested positive for COVID-19.

Nausea or Vomiting

An upset stomach, including nausea or vomiting, is also a symptom of COVID-19, especially when in conjunction with other common symptoms.

Diarrhea 

Loose or runny stool can occur as a result of COVID-19. Diarrhea may start at the beginning of infection or be one of the last symptoms to manifest. However, many people with COVID-19 do not have any gastrointestinal discomfort as part of their illness.

Rare Symptoms

A few rare symptoms may also occur as a result of COVID-19.

“COVID Toes”

COVID toes, a red or purple discoloration of the toes accompanied by inflammation that may be itchy or painful, is a symptom that has cropped up across the age spectrum, in children and adults, who have been diagnosed with COVID-19.

Pink Eye

Pink eye, also called conjunctivitis, can also develop because of COVID-19. You may experience red, itchy, or watery eyes or blurred vision.

Delirium

In cases of severe COVID-19, extreme confusion may occur as a result of the disease’s impact on the central nervous system. If this occurs in someone you’re caring for, seek immediate medical attention.

Deep Vein Thrombosis

Observational studies show that people with COVID-19 are at heightened risk for deep vein thrombosis, also known as a blood clot, in their lower extremities. A blood clot can result in a pulmonary embolism if it travels to the blood vessels of the lungs. Watch your legs for swelling, cramping, a change in color, or itching. And monitor yourself for trouble breathing. Seek medical attention if any of these symptoms occur.

Stroke

The heightened risk of blood coagulation or clotting as a result of COVID-19 could lead to a stroke, although this symptom is rare. People with underlying cardiovascular conditions are more at risk of a stroke if they contract COVID-19. Keep an eye out for weakness, slurred speech, or confusion. Seek immediate medical attention if any of these symptoms occur.

Complications 

Complications from severe COVID-19 include the following:

Although anyone can develop COVID-19, age increases your risk for severe complications. Individuals with certain underlying medical conditions are also at an increased risk for severe illness if they become infected with SARS-CoV-2. 

People with Certain Pre-Existing Medical Conditions 

The CDC lists the following medical conditions as risk factors for developing a severe case of COVID-19 if infected:

The CDC also states medical conditions that might put people at an increased risk for developing severe illness from COVID-19 include:

Children with Certain Pre-Existing Medical Conditions 

Children appear to be less likely to be affected by Covid-19. However, according to the CDC, the following pre-existing conditions may increase the risk of severe illness from the virus:

When to See a Doctor or Go to the Hospital 

If you have worsening COVID-19 symptoms or symptoms that concern you, you should call your health care provider. The CDC lists five COVID-19 warning signs that indicate you should seek emergency medical attention by calling 911 or calling ahead to your local emergency room:

• Difficulty breathing
• Persistent pain or pressure in the chest
• New confusion 
• Inability to stay awake
• Bluish lips or face 

What This Means For You

Reading about the COVID-19 pandemic and symptoms of infection can be overwhelming. Remember, not everyone who develops COVID-19 will experience symptoms. Although some people will have severe symptoms, others will have a milder illness. Researchers are learning more about COVID-19 every day and working to find the right treatments to help with severe cases. To protect yourself and others from COVID-19, wear a mask in public and maintain a distance of at least six feet from those who don’t live with you. 

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

Chief medical officer explains the common COVID-19 symptoms – Jagwire

Researchers are discovering more each day about COVID-19 and the varying symptoms the disease causes.

The most common symptoms of the mysterious novel coronavirus include fever, cough and shortness of breath. But Augusta University Health Chief Medical Officer Dr. Phillip Coule says there are additional symptoms of the virus that mimic the common cold or flu.

“COVID-19 symptoms can be experienced within 14 days of being exposed to the virus, which is why the public needs to recognize the signs to protect themselves and their loved ones,” said Coule.

Below are indicators Coule says to look for if you think you or a loved one has COVID-19.

Fever

A key sign of COVID-19 is a fever, which indicates the body’s temperature is 100 degrees Fahrenheit or higher. Since everyone’s core temperature changes throughout the day, check your temperature in the early to late afternoon for a more accurate reading. If the fever lasts more than two to five days, seek medical attention.

Shortness of breath

Considered to be the most serious of the symptoms, shortness of breath is not always the first symptom to appear, and it can occur without a cough. If the chest feels tight or you can’t breathe deeply, seek medical attention right away.

Upset stomach

Although cough and fever are usually the initial signs of COVID-19, it’s important to know that abdominal pain, vomiting and diarrhea can happen before respiratory symptoms appear. If these symptoms continue to worsen, it may not be a stomach bug but a sign of a more serious condition, like the coronavirus.

Tiredness and body aches

Many patients with COVID-19 experience fatigue, flu-like chills, and achy joints and muscles. A recent report from the World Health Organization stated nearly 40% of COVID-19 patients had moments of tiredness. Although these symptoms happen with the flu, it could be the coronavirus if things don’t improve after a week or so.

Dry cough

A dry cough is felt deep within the chest with no mucus or phlegm being produced. Dry coughs can be a symptom of a variety of other illnesses, including allergies and asthma. However, if you are coughing and experiencing other symptoms related to COVID-19, consider getting tested for the coronavirus.

Moments of confusion

Sudden confusion or the inability to be alert is a serious symptom of COVID-19, and emergency care should be given.

Headaches, sore throat and congestion

Headache is not a common COVID-19 symptom, but nearly 14% of patients experienced it, according to the Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). Sore throat and congestion can also be signs of the common cold or flu, but they can also indicate a more serious condition, such as COVID-19. So, get tested if your symptoms worsen or last longer than normal.

Loss of smell and taste

In mild to moderate COVID-19 cases, the loss of smell and taste, or anosmia, seems to be an early sign of the virus. However, anosmia can also be a result of the common cold, congestion or medications. If you believe you’re experiencing anosmia and do not have a medical reason to explain the loss, take the symptom seriously and get tested.

Patients concerned about COVID-19 can now be screened for the virus by using the AU Health COVID-19 Virtual Screening website or downloading the AU Health Express Care app for Apple or Android devices. Through the new telehealth platform, patients can now receive free virtual screenings for coronavirus, 24 hours a day, seven days a week, with no appointment required.

Read the latest news on COVID-19 on our dedicated resource page , and check out the Augusta University Expert Center to view a complete list of our experts.

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Diarrheal Diseases – Acute and Chronic

Overview

Acute diarrhea is one of the most commonly reported illnesses in the United States, second only to respiratory infections. Worldwide, it is a leading cause of mortality in children younger than four years old, especially in the developing world. Diarrhea that lasts less than 2 weeks is termed acute diarrhea. Persistent diarrhea lasts between 2 and 4 weeks. Chronic diarrhea lasts longer than 4 weeks.

Symptoms

Diarrheal stools are those that take shape of the container, so they are often described as loose or watery. Some people consider diarrhea as an increase in the number of stools, but stool consistency is really the hallmark. Associated symptoms can include abdominal cramps fever, nausea, vomiting, fatigue and urgency. Chronic diarrhea can be accompanied by weight loss, malnutrition, abdominal pain or other symptoms of the underling illness. Clues for organic disease are weight loss, diarrhea that wakes you up at night, or blood in the stools. These are signs that your doctor will want to do a thorough evaluation to determine the cause of your symptoms. Also tell your doctor if you have a family history of celiac disease, inflammatory bowel disease (IBD), have unintentional weight loss, fever, abdominal cramping or decreased appetite. Tell your doctor if you experience bulky, greasy or very bad smelling stools.

Causes – Acute Diarrhea

Most cases of acute, watery diarrhea are caused by viruses (viral gastroenteritis). The most common ones in children are rotavirus and in adults are norovirus (this is sometimes called “cruise ship diarrhea” due to well publicized epidemics). Bacteria are a common cause of traveler’s diarrhea.

Causes – Chronic Diarrhea

Chronic diarrhea is classified as fatty or malabsorption, inflammatory or most commonly watery. Chronic bloody diarrhea may be due to inflammatory bowel disease (IBD), which is ulcerative colitis or Crohn’s disease. Other less common causes include ischemia of the gut, infections, radiation therapy and colon cancer or polyps. Infections leading to chronic diarrhea are uncommon, with the exception of parasites.

The two major causes of fatty or malabsorptive diarrhea are impaired digestion of fats due to low pancreatic enzyme levels and impaired absorption of fats due to small bowel disease. These conditions interfere with the normal processing of fats in the diet. The former is usually due to chronic pancreatitis which is a result of chronic injury to the pancreas. Alcohol damage to the pancreas is the most common cause of chronic pancreatitis in the United States. Other causes of chronic pancreatitis include cystic fibrosis, hereditary pancreatitis, trauma to the pancreas and pancreatic cancer.

The most common small bowel disease in the U.S. is celiac disease, also called celiac sprue. Crohn’s disease can also involve the small bowel. Whipple’s disease, tropical sprue, and eosinophilic gastroenteritis are some of the rare conditions that can lead to malabsorption diarrhea.

There are many causes of watery diarrhea, including carbohydrate malabsorption such as lactose, sorbitol, and fructose intolerance. Symptoms of abdominal bloating and excessive gas after consuming dairy products suggests lactose intolerance. This condition is more common in African-Americans and Asian-Americans. Certain soft drinks, juices, dried fruits and gums contain sorbitol and fructose, which can lead to watery diarrhea in people with sorbitol and fructose intolerance. Diarrhea is a frequent side effect of antibiotics. Certain other medications such as NSAIDs, antacids, antihypertensives, antibiotics and antiarrhythmics can have side effects leading to diarrhea.

Parasitic intestinal infections such as giardiasis can cause chronic diarrhea. Diabetes mellitus may be associated with diarrhea due to nerve damage and bacterial overgrowth; this occurs mainly in patients with long-standing, poorly-controlled diabetes.

Irritable bowel syndrome (IBS) is a condition often associated with diarrhea, constipation or more frequently alternating diarrhea and constipation. Other common symptoms are bloating, abdominal pain relieved with defecation and a sense of incomplete evacuation.

Risk Factors

Exposure to infectious agents is the major risk factor for acute diarrhea. Bacteria and viruses are often transmitted by the fecal-oral route, so hand washing and hygiene are important to prevent infection. Soap and water are better because alcohol-based hand sanitizers may not kill viruses. Medications such as antibiotics and drugs that contain magnesium products are also common offenders. Recent dietary changes can also lead to acute diarrhea. These including intake of coffee, tea, colas, dietetic foods, gums or mints that contain poorly absorbable sugars. Acute bloody diarrhea suggests a bacterial cause like Campylobacter, Salmonella or Shigella or Shiga-toxin E. coli. Traveler’s diarrhea is common in those who travel to developing countries and results from exposure to bacterial pathogens most commonly enterotoxigenic E. coli. The best method of prevention is to avoid eating and drinking contaminated or raw foods and beverages.

Screening/Diagnosis

Most episodes of acute diarrhea resolve quickly without antibiotic therapy and with simple dietary modifications. See a doctor if you feel ill, have bloody diarrhea, severe abdominal pain or diarrhea lasting more than 48 hours. In patients with mild acute diarrhea, no laboratory evaluation is needed because the illness generally resolves quickly. Your doctor may perform stool tests for bacteria and parasites if your diarrhea is severe or bloody or if you traveled to an area where infections are common. If you have severe diarrhea, blood tests will be helpful to guide replacement of fluid and electrolytes and minerals such as magnesium, potassium and zinc that can become depleted.

If you have chronic diarrhea, your doctor will want to further assess etiologic factors or complications of diarrhea by obtaining several tests. These can include a blood count to look for anemia and infections, an electrolyte and kidney function panel to assess for electrolyte abnormalities and renal insufficiency, and albumin to assess your nutritional status.

A stool sample may help define the type of diarrhea. The presence of fat, microscopic amounts of blood, and white blood cells will help determine if a fatty, inflammatory, or watery diarrhea is present. A bacterial culture and ova/parasite studies of a stool specimen will also help determine if an infectious etiology is present.

Endoscopic examination of the colon with flexible sigmoidoscopy or colonoscopy and upper endoscopy are helpful in detecting the etiology of chronic diarrhea, as this allows direct examination of the bowel mucosa and the ability to obtain biopsies for microscopic evaluation. Double-balloon enteroscopy and capsule endoscopy are sometimes used to examine the mucosa of the small intestine that lies beyond the reach of conventional endoscopes.

Radiographic studies such as an upper GI series or barium enema are not routinely performed in the evaluation of chronic diarrhea, and have largely been replaced by cross-sectional imaging. Ultrasound and CT scan of the abdomen can be helpful to evaluate the bowel, pancreas and other intra-abdominal organs.

Treating Acute Diarrhea

It is important to take plenty of fluid with sugar and salt to avoid dehydration. Salt and sugar together in a beverage help your intestine absorb fluids. Milk and dairy products should be avoided for 24 to 48 hours as they can make diarrhea worse. Initial dietary choices when refeeding should begin with soups and broth.

Anti-diarrheal drug therapy can be helpful to control severe symptoms, and includes bismuth subsalicylate and antimotility agents such as loperamide. These, however, should be avoided in people with high fever or bloody diarrhea as they can worsen severe colon infections and in children because the use of anti-diarrheals can lead to complications of hemolytic uremic syndrome in cases of Shiga-toxin E. coli (E. coli 0157:H7).

Your doctor may prescribe antibiotics if you have high fever, dysentery, or moderate to severe traveler’s diarrhea. Some infections such as Shigella always require antibiotic therapy.

Treatment of chronic diarrhea depends on the etiology of the chronic diarrhea. Often, empiric treatment can be provided for symptomatic relief, when a specific diagnosis is not reached, or when a diagnosis that is not specifically treatable is reached.

Antimotility agents such as loperamide are the most effective agents for the treatment of chronic diarrhea. They reduce symptoms as well as stool weight. Attention should be paid to replacing any mineral and vitamin deficiencies, especially calcium, potassium, magnesium and zinc.

Author(s) and Publication Date(s)

Blanca Ochoa, MD and Christina M. Surawicz, MD, MACG, University of Washington School of Medicine, Seattle, WA – Published October 2002. Updated April 2007. Updated December 2012.

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Coronavirus symptoms linger weeks, months later

We’re continuing to learn a lot about the coronavirus now, almost seven months into this pandemic.

One thing that is becoming clear is that the symptoms continue to linger weeks to even months after the initial diagnosis for some people.

A recent Centers for Disease Control and Prevention study, which conducted phone interviews with people who had a positive COVID-19 test two to three weeks earlier, showed that 35 percent of those who had been symptomatic had not returned to their pre-COVID-19 health. That was true across age groups: 26 percent for people ages 18-34, 32 percent for people ages 35-49 and 47 percent for people 50 years old or older. It was also true for people who did not have any pre-existing condition before getting COVID-19.

The most common symptom that lingers is the cough, but people also reported fatigue, difficulty breathing, congestion, sore throat, chest pain, headache, body aches, fever, chills, loss of taste or smell, diarrhea, nausea, vomiting, abdominal pain, and confusion.

“COVID is really going to multiple body organs,” says Dr. Esther Melamed, an assistant professor of neurology at Dell Medical School at the University of Texas at Austin. “It weakens the entire body of people who have it.”

Melamed says there is even a term for those patients who are still experiencing symptoms weeks to months later: “long-haulers.”

For her patients, how long it lasts doesn’t seem to have a connection to how severe their disease was in the first place, she says.

Several of her patients who had a mild case are still reporting severe fatigue, lack of motivation and mood changes more than a month to two months later, she says.

Melamed and her colleagues at UT and Dell Medical School are part of a 15-site National Institutes of Health study to understand the immunology of COVID-19.

“We’re fighting the virus by trying to understand it,” she says.

Like the flu, COVID-19 can weaken a person, making them more susceptible to other viruses and pneumonia. That’s why doctors are urging people to get the flu shot this year because they fear what will happen if a person gets the flu then gets COVID-19 or vice versa.

Unlike the flu, though, it’s not just the respiratory symptoms. It’s affecting the brain, the spine, digestion and muscles including the heart.

The other thing that Melamed and doctors around the country are starting to understand about the virus is that people can become reinfected with a different strain of it. The reinfection might be milder or it might be more severe.

There are things people can do to try to improve the course of their disease. Melamed recommends a proper diet with a lot of fruit and vegetables, protein and antioxidants like those found in berries. As well, she recommends a lot of Vitamin D, sleep and taking care of their mental health.

If you are still having symptoms of COVID-19 weeks later, see your doctor. Things like an inhaler could be helpful for the breathing; physical therapy and occupational therapy might also be needed for the other symptoms.

Decreased appetite

30613

12-th of September

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests.For a diagnosis and correct prescription of treatment, you should contact your attending physician.

Decreased appetite – the causes of the appearance, in what diseases it occurs, the diagnosis and methods of treatment.

Decreased appetite occurs under the influence of various factors. Natural causes can be satiety, fatigue, or a preoccupation with an activity. However, in some cases, poor appetite can be a symptom of the disease, and you should pay attention to this.

Species

Depending on the degree of impaired appetite, hyporexia is distinguished – a decrease in appetite and anorexia – an almost complete lack of appetite.

Sometimes there may be an idiosyncrasy (painful reaction) to a food or dish. In some cases, it may not be about loss of appetite, but about quick satiety, for example, after surgery on the intestines or stomach.

Possible causes and diseases in which there is a decrease in appetite

The formation of a feeling of hunger and satiety occurs in the brain, where signals are received from nerve endings (for example, from receptors when the stomach is stretched) and substances (hormones, glucose, toxins) carried by the blood.

Intoxication of the body often leads to a decrease in appetite.

The cause of intoxication can be infectious diseases, which are accompanied by the release of waste products of microorganisms into the blood. These toxins, through a chain of biochemical reactions, cause suppression of the food center, which leads to a decrease in appetite. The same mechanism is triggered by tumor decay products. Dying under the influence of drugs, tumor cells release substances into the blood that contribute to a decrease in blood pH (acidification), which, in addition to affecting the food center, can lead to kidney failure, fever, nausea, and vomiting.

Decrease and lack of appetite are characteristic of endocrine disorders (pituitary and adrenal insufficiency, hypothyroidism, diabetes mellitus).

The causes of pituitary insufficiency are most often tumors, hemorrhages, or infectious processes.

Hypothalamic-pituitary insufficiency in most cases occurs in young women under the age of 40.

Lack of thyroid-stimulating hormone, leading to the development of hypothyroidism, is also accompanied by loss of appetite, apathy, decreased blood pressure, and constipation.Depletion due to a lack of pituitary hormones leads to disturbances in the field of thinking and intelligence.

The overwhelming majority of patients with diabetes mellitus gradually develop concomitant diseases of the gastrointestinal tract, which are combined by the “gastroenterological” form of autonomic diabetic neuropathy. In this case, the disorder of the functions of the digestive system is due to a greater extent to a violation of glucose uptake and a change in the structure of the walls of blood vessels.Symptoms are dominated by increased salivation, impaired motility of the esophagus, stomach (gastroparesis), decreased acidity of the stomach, heartburn and impaired swallowing. The defeat of the intestine is manifested by a weakening of peristalsis, up to paresis, and diarrhea. A decrease in appetite in this disease is associated with a violation of the production of the hormone ghrelin in the stomach, which is called the hormone of hunger. Gastroparesis can be suspected with severe and persistent nausea, pain, distention in the epigastric region after eating, and a feeling of early satiety.

Diseases of the gastrointestinal tract are accompanied by a decrease in appetite due to pain and dyspeptic syndrome.

Gastroduodenitis, gastric ulcer and duodenal ulcer may be accompanied by either excessive or insufficient secretion of hydrochloric acid, infection with Helicobacter pillory bacteria.

These factors cause the development of inflammation and the formation of erosions on the gastric mucosa.Ingestion of food in the stomach causes heartburn and pain.

Disruption of food digestion due to inflammatory and infectious processes in the intestine (colitis) is also accompanied by dyspeptic symptoms (diarrhea, rumbling in the abdomen, cramping pain), which lead to loss of appetite.

The pain syndrome characteristic of pancreatitis (inflammation of the pancreas) always leads to a decrease in appetite. Dyspeptic syndrome, which manifests itself with an exacerbation of the disease, is accompanied by nausea, decreased or lack of appetite, sometimes vomiting, belching, less often – heartburn, bloating, and rumbling in the abdomen.Frequent exacerbations lead to weight loss and asthenia.

Decreased appetite is typical for patients with liver and kidney diseases, which is explained by the appearance of nausea and vomiting in such patients due to intoxication of the body.

Psychogenic and neurological causes contribute to the development of hypo- and anorexia.

Stress, depression, anxiety suppress appetite responses, making diagnosis and treatment difficult.

Studies have noted that patients with nervous and mental (schizoid) disorders are often indifferent not to food, but to the feeling of hunger. They simply do not notice it, being under the influence of other emotional stimuli. In elderly patients with dementia, lack of appetite is one of the indicators of disease progression.

Characterized by a decrease in appetite in people addicted to drugs, smoking and alcohol, which is caused by intoxication and changes in metabolism at all levels.Metabolic disorders and decreased appetite are also observed in persons adhering to a rigid protein diet.

Taking some medications, which can be conditionally divided into adrenaline and serotonin, may also be accompanied by a decrease in appetite.

Particular attention should be paid to loss of appetite in children, as insufficient nutrition can cause impaired physical development and serious illness.

In newborns, a decrease in appetite occurs against the background of difficulty in the act of sucking with rhinitis, diseases of the oral mucosa and other conditions.In addition, in infants, a decrease in appetite is observed with overfeeding, especially in the case of a high-protein diet, and also as an act of protest during force-feeding.

In school-age children, neurogenic anorexia is sometimes observed due to pathological dissatisfaction with their appearance and body weight.

Which doctors should I contact?

As a rule, patients with complaints of loss of appetite turn to
a therapist who, after preliminary diagnosis and obtaining the results of clinical and biochemical blood tests, directs the patient to
gastroenterologist,
endocrinologist, psychotherapist or oncologist.Sometimes, when the infectious nature of the disease is detected, the patient is referred to an infectious disease specialist.

Diagnostics and examinations

In case of complaints of decreased appetite, the therapist assesses the patient’s appearance (jaundice, thyroid condition, sweating, type of skin), during the survey, assesses the accompanying symptoms (pain, nausea, vomiting). For general information, the doctor prescribes a general clinical

90,000 Do I need to purify water? Caution, giardiasis!

All published information about giardia is confusing and inconsistent, like the parasite itself.Giardia is a multifaceted protozoan that affects people in different ways. They can be concentrated in one small area of ​​the lake and practically absent in other parts of the same reservoir. In natural waters, Giardia is rarely diagnosed or recorded and, unfortunately, there has not been enough scientific research to assess the risks to travelers. To complicate matters further, the symptoms that cause giardia are difficult to distinguish from those of cryptosporidium, another parasite.On the one hand, many seasoned travelers regularly drink untreated water without experiencing symptoms. They have developed a kind of immunity that allows the body to fight bacteria. But giardia can be a problem for less prepared tourists. MSR advises filtering or purifying the water to eliminate the possibility of Giardia infestation. Our article is devoted to lamblia so that you can assess the risks and make your own decision regarding filtering.

Water filters MSR

How does Giardia infestation occur?

They are usually spread through the faeces of an infected person or animal.They can be found in latrines, childcare facilities, bodies of water, and raw food. Research shows that many infections are the result of person-to-person transmission of bacteria. This happens easily, especially when traveling. Good hygiene and regular use of hand sanitizers will reduce this risk.

Unfortunately, humans are not the only carriers of Giardia. They also live in pristine nature. There are about 40 species of giardia that infect livestock, sheep, deer, rodents and even birds.They can be present in the water at any height. In addition, a source of water, such as a lake, may have a high concentration of cysts in one part and very little in others. The good news is that, with the exception of rangelands, concentrations of Giardia in the wild are usually low. Alpine water sources that do not stagnate are even less likely to contain giardia. The likelihood of infection from such a source is quite low, but still not excluded.

What Happens When Infected?

Some people get infected very easily.Even a small concentration of lamblia can “disable” a person with a weak immune system. People with stronger immune systems can deal with many more bacteria before they experience any symptoms. Someone does not experience any symptoms at all. Signs of infection can appear in everyone in their own way, it all depends on your immune system and the number of lamblia cysts that have got inside. The approximate range of onset of the first symptoms is from 48 hours to 25 days. Giardia reproduces in the small intestine.This leads to unpleasant, but usually not life-threatening diseases.

Symptoms

Diarrhea, abdominal pain, nausea, vomiting, convulsions, fever, fatigue, headache, chills.

Diagnosis

The symptoms of giardiasis are similar to those of cryptosporidium and a number of similar diseases. A specific diagnosis requires stool samples and a number of other tests, the results of which can be obtained in a week or more. In most cases, the doctor and patient decide to start general treatment without waiting for a specific diagnosis.

Treatment

Giardiasis is often treated with a strong dose of antibiotics. However, the side effects of these drugs can compete in lethality with the parasite itself.

Using Filters

U.S. Standards EPA requires the removal of 99.9% of Giardia cysts. All MSR water filters comply with this standard, including the MiniWorks, SweetWater and AutoFlow systems. Cleaning tablets such as MSR Aquatabs can also be effective in water without particulate matter (usually prefiltered).Giardia is not the only potential hazard in natural water sources. MSR recommends filtering or purifying all natural water.

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Translated by Yulia Smolyaninova

90,000 Dangerous symptoms. | Medical Center “Tet-a-Tet”

Someone likes to self-medicate, others run to the doctor at every tiny symptom of possible ill health. What conditions require a medical consultation and how long should you wait if something is wrong with you?

Abdominal pain

Stomach pain can occur due to a huge variety of reasons.In any case, there is only one recipe: if the pain does not go away on its own within one hour, and you do not know what may be causing it (for example, flatulence, indigestion, the first day of the menstrual cycle), you should consult a doctor. For pain of unclear etiology, it is strongly discouraged to take painkillers, as they can interfere with the diagnosis.

Headache

Chronic sleep deprivation, constant stress, long work at the computer or taking certain medications are common causes of headaches.If none of these reasons work for you, if walking, sleeping, exercising, showering and mild pain reliever do not help, and the pain does not subside within three days, go to the doctor.

Temperature rise

An increase in body temperature is a sign that the body is fighting the inflammatory process. It is worth calling a doctor when:

• Fever is accompanied by the following symptoms: rash, cough, runny nose, general weakness, intoxication, loss of appetite, drowsiness, headache, abdominal pain, visual impairment, muscle tension, vomiting.
• There was a sharp (within a couple of hours) temperature rise to 38.5o C or more.
• Your body temperature has risen to 37.5o C and you have a history of febrile seizures.
• Subfebrile temperature (37-38o C) without other symptoms persists for more than three days.

Noise and ringing in the ears

Since tinnitus may indicate impaired cerebral circulation, you should consult a doctor if you hear extraneous sounds for more than two days and do not experience stress, sleep problems, do not smoke or do not abuse coffee, tea, salt and aspirin …Dizziness and impaired coordination of movements accompanying ringing in the ears is an indicator that you need medical attention immediately.

Change in the number or condition of moles

You should immediately consult a doctor if:

• The mole has increased in size.
• The color and shape of the mole has changed.
• You have pain, itching, or burning around the mole.
• There is redness around the mole.
• The edges of the mole are out of focus.
• The mole has begun to peel off or bleed.

Heart rhythm disorders

If you are concerned about frequent heart rhythm disturbances, especially accompanied by chest pain, dizziness, shortness of breath, blurred vision, you should consult a doctor.

Hair loss

A doctor (endocrinologist, trichologist or dermatologist) should be consulted if you notice that you have more than a hundred hairs falling out every day within two to three weeks.

Urine discoloration

If you do not associate a change in yellow urine color to any other color (especially red) with taking certain medications or eating urine-staining food, schedule a visit to your doctor in the coming days. If you notice thin blood cords or blood clots in your urine, go to your medical appointment immediately.

You should also consult a doctor in the following cases:

• With a decrease in visual acuity and hearing.
• For any changes in the condition of the skin (yellowness, rash, pustules, spots).
• With persistent itching.
• For discomfort of the genitourinary organs (itching, pain when urinating, changes in the nature and smell of discharge).
• For bad breath.
• With increased sweating.
• With prolonged lack of appetite and persistent nausea.
• With constant lacrimation, redness of the eyes, swelling of the eyelids.
• For lethargy, drowsiness, sleep disturbances and unwillingness to move.
• For sudden mood swings, constant agitation and increased irritability.
• With the disappearance or significant decrease in libido.

Fedorova Lyubov Alekseevna – therapist, doctor of the first category, cardiologist of the Tet-a-tet medical center.

Update Covid 9: 19 Nov

19 November 2020

Dear Parents / Guardians & Students:

We learned today that a person in New Castle Elementary School tested positive for COVID-19.

The last time a person was in the building was Friday, November 13th. This person will not return to school until the isolation period has passed.

Our DPH partners will contact anyone who has had close contact with this person as determined by the Public Health Department and may need to be quarantined for 14 days before returning to school. Individual quarantine decisions are made by DPH epidemiologists after consultation with the victim and may depend on whether the person was wearing a mask.

Please visit https://coronavirus.delaware.gov to learn more about DPH protocols for positive COVID-19 cases in schools. We always recommend that you monitor your child for any symptoms of COVID-19. If a student or staff member has any of the following symptoms, stay at home: fever, cough, shortness of breath, sore throat, muscle aches, fatigue, chills, shivering from chills, loss of smell or taste, nausea or vomiting, diarrhea, headache, nasal congestion or a runny nose for no known cause, such as allergies.Our School Nurses are ready to support your family by looking at symptoms to watch for, answering questions you may have, helping with follow-up communication, and providing more information about available testing sites. Testing for COVID-19 is free and available in our local community. DPH encourages all Delaware residents, whether you are experiencing symptoms or not, to consider testing for free. This will help our state more accurately track the spread of the disease and keep our communities healthy.

Play https://coronavirus.delaware.gov/testing/ for the latest updates on COVID-19 in Delaware and information on free COVID-19 testing in Delaware. The Colonial School District has strict cleaning, social distancing, and hygiene practices. This is our best defense against COVID-19 and its spread. District guardians are aware of positive cases and follow prescribed cleaning protocols in accordance with the most recent health guidelines from the Centers for Disease Control and Prevention (CDC) and DPH.

As a precautionary measure , all Colonial School District schools have switched to virtual teaching as of Monday, November 16, 2020 Please continue to follow our website at www.colonialschooldistrict.org and social media for the latest updates as we strive to fully inform families.

With the holidays approaching Delaware Public Health advises Delawareans to take the following actions to prevent further spread of infection in the community:

• Dine only in the community (at home and in restaurants) with those who live with you
• Don’t spend time with people outside your family
• Do not plan holiday dinners with people outside of your family, even your family.

Sincerely, John Cooper, EdD.
District COVID-19 Coordinator

90,000 Pyelonephritis – symptoms, prevention and treatment

The main / Pyelonephritis – symptoms, prevention and treatment

Pyelonephritis is a bacterial inflammation of the kidneys, or rather its pelvis and parenchyma. This pathology may be secondary, that is, it may arise due to other kidney diseases (for example, urolithiasis, glamerulonephritis), or it may be primary (for example, against the background of hypothermia).
The most common causative agents of this disease are staphylococci, streptococci, enterococci, proteas, Escherichia coli, Klebsiella.

The main provoking factors of pyelonephritis. Knowing the main provoking factors of the onset of the disease, it is possible to prevent the occurrence of a chronic form of inflammation and the development of complications:

1. Hypothermia.
2. Pyelonephritis appeared earlier.
3. Diseases of the genitourinary system (glamerulonephritis, urethritis, cystitis, kidney stones.).
4. Inflammatory diseases (tonsillitis, sinusitis, etc.).
5. Untreated pyelonephritis.
6. Frequent stress, overexertion.
7. Weakening of the immune system.
8. Diabetes mellitus.
9. Pregnancy.
10. Injury to the kidneys and bladder.
11. Prolonged stagnation of urine in the bladder.
12. Anomalies of the genitourinary system.
13. The presence of hypovitaminosis (lack of vitamins).
14. HIV infection (provokes the occurrence of other diseases, including pyelonephritis).Women are more prone to pyelonephritis than men due to the anatomical structure of the urogenital system of women. They have a wider and shorter urethra, so infection can easily reach the kidneys.

Signs of acute pyelonephritis . This ailment usually makes itself felt with high fever, vomiting, lethargy, unpleasant sensations in the muscles, as well as chills. After two to three days, you may experience lower back pain. In such cases, urination usually becomes painful and the urine is cloudy.Before back pain appears, you may have discomfort in your groin.

General symptoms of acute pyelonephritis:

1. Sharp chills.
2. Febrile body temperature (39-40 degrees).
3. Urination becomes rapid and painful.
4. Sweating.
5. Intense thirst.
6. Dyspeptic disorders (general malaise, abdominal pain, nausea, vomiting, diarrhea).
7. Intoxication of the body (headaches, severe fatigue, deterioration of health).

Local symptoms:

1. Pain in the affected kidney. (Dull, aching, constant pain, worse during any movement).
2. Identification of a positive symptom of Pasternatsky (pain occurs when the edge of the palm of the hand is tapped on the kidneys).
3. Tension and soreness of the muscles of the abdominal wall with the subsequent occurrence of kidney infiltration.

There are also clinical forms of acute pyelonephritis:

1.The sharpest. (The patient’s condition is very serious, the body temperature rises to 39-40 degrees and severe chills, repeated several times a day, about 2-3 times).

2. Sharp. (Symptoms are also present, but to a lesser extent than in the previous form, there is intoxication of the body, severe dehydration and chills).

3. Subacute. (Here, local symptoms are already more pronounced than acute ones, which are either mild or absent altogether).

4. Latent, otherwise hidden.This form of pyelonephritis does not threaten the patient’s life, but it can become chronic.
If you find such symptoms, you should immediately consult a doctor (urologist or nephrologist) for further diagnosis and treatment! You should not postpone a visit to a specialist, and even more so to self-medicate!

The described disease is detected by urine analysis. Symptoms of peritonitis sometimes occur. Pyelonephritis is often confused with abdominal ailments. It can be mistaken for a stomach ulcer, appendicitis, or something else.

If we are talking about primary pyelonephritis , then renal dysfunction is usually not observed.

Signs of chronic pyelonephritis

This form has a quieter flow. Symptoms are not as pronounced as in the acute form. Sometimes, symptoms may be absent, but after a while the chronic form manifests itself. Most often, it is the acute form that provokes the onset of the chronic.

In total, the following clinical forms of chronic pyelonephritis are distinguished: :

1.Latent (latent form) – characterized by minimal manifestation of symptoms. Patients may feel only severe weakness, fatigue, fever up to 37 degrees, headache, swelling, pain and discomfort in the lumbar region. Some people may have a positive Pasternatsky symptom. In urine tests: slight proteinuria (protein in the urine), leukocyturia (leukocytes in the urine) and bacteriuria (bacteria in the urine), sometimes the patient may be accompanied by hypertension.

2.Recurrent is a form during which exacerbations and remissions alternate. A person feels constant discomfort in the area of ​​an inflamed kidney, a slight increase in temperature to subfebrile levels (37 – 38 degrees) and chills. During an exacerbation, pyelonephritis manifests itself in the form of an acute form of inflammation.

3. Hypertensive is a form in which symptoms of hypertension are manifested. Patients have dizziness, headaches, deterioration in general health, insomnia, pain in the heart, shortness of breath, hypertensive crises.

4. Anemic form – characterized by severe symptoms of anemia. The patient feels rapid fatigue, fatigue, deterioration in working capacity, weakness, etc.

5. Azothermic is the most unexpected, dangerous and hidden form of disease manifestation. It manifests itself only when a person has already begun chronic renal failure (chronic renal failure). It is believed that this form is a further continuation of the latent form untimely identified.

Edema is rare.Frequent urination is sometimes encountered. The result is dry skin and constant thirst. This ailment is diagnosed through kidney x-rays and urea studies.

Pyelonephritis in babies. If this ailment occurs in a baby, he, as a rule, experiences discomfort in the abdomen. This is accompanied by indigestion. The crumb can lose several pounds. Sometimes it is quite difficult to determine the cause of this condition. This is usually done by examination.

Violation of urination makes itself felt in different ways. The child may have bedwetting. Note that it can be both rare and frequent.

Treatment of acute and chronic forms of pyelonephritis:

Treatment is carried out only by a urologist or a nephrologist. Depending on the severity of the course of the disease and the duration, the doctor may prescribe the following treatment principles:

1. Conservative etiotropic therapy (drugs).For the treatment of all forms of pyelonephritis, antibiotics of various groups (penicillins, cephalosporins, fluoroquinolones, etc.) are used, such as amoxicillin, ampicillin, gentamicin, cefaclor, ciprofloxacin, etc .; sulfonamides: sulfadimezin, urosulfan and others; nitrofurans: eg furazolin, furagin; nalidixic acid (nalidix, negro.), non-steroidal anti-inflammatory drugs (diclofenac, metamizole, etc.), antispasmodics (nosh-pa, papaverine), enterosorbents (for example, activated carbon), anticoagulants (drugs that thin the blood): heparin, troxevasin; diuretics (furosemide, lasix, etc.) With prolonged treatment of pyelonephritis , it is necessary to take probiotics and antifungal drugs, since antibiotics can provoke the appearance of bacteria of a fungal nature in the body. If there are contraindications to antibiotic therapy or it is desirable to add additional treatment, then phytopreparations are used that include individual useful herbs, or complex fees that include several herbs. Common herbs: lingonberry leaf, cornflower flowers, bearberry, wild rose, black poplar buds and others.Herbal preparations: phytolysin, uroflux, etc.
Phytopreparations also have anti-inflammatory, diuretic and antibacterial effects. There is the most common herbal phytopreparation – kanefron. Has all of the above.

2. Physiotherapy. This is more of an additional method than the main one. Physiotherapy helps to improve the condition, kidney function and accelerate the effect of etiotropic therapy.
Types of physiotherapy: electrophoresis of furadonin or calcium chloride (other drugs can also be used), ultrasound (if there are no kidney stones), thermal effects on the kidneys (for example, diathermy, therapeutic mud, etc.)etc.), microwave therapy, etc.

3. If all methods of treatment turn out to be useless, and the patient’s condition remains the same or worsens, then a surgical method is used. Basically, surgery is performed with purulent pyelonephritis, kidney carbuncle or abscess. Depending on the condition, the doctor himself chooses the type of surgical correction.

Complications of pyelonephritis:

Unfortunately, it is not always possible to recover safely and forget about this disease.If you do not visit a doctor, do not fulfill his appointment, or, in general, do not check, then the following complications may appear:
1. Violation of the filtration function of the kidneys.
2. Chronic renal failure.
3. Sepsis.
4. Accumulation of pus in the kidneys. (Otherwise, pyonephrosis).
5. Paranephrite. (Inflammation of the perineal tissue).

Prevention of pyelonephritis:

1. Dress for the season. Try to keep your lumbar area under a layer of warm clothing.
2.Treat inflammation in the body, because they can also cause pyelonephritis.
3. Visit the polyclinic twice a year for a routine check-up.
4. Maintain personal hygiene.
5. Try not to overcool.
6. If you already have pyelonephritis, then visit a urologist, nephrologist and follow all his appointments.
7. In which case, do not self-medicate.
8. Follow a diet (exclude salty, canned food and bakery products, if there is edema and increased blood pressure, then limit the use of water and drinks containing caffeine).
9. If you feel unwell, call a doctor immediately!

For questions treatment of pyelonephritis you can contact our clinic “MC For the whole family”, located at Irkutsk, st. Railway, 2nd, 74. Phone: +7 (3952) 390 – 292.

Prevention of intestinal infections | Website for KFU students

Intestinal infections are a combination of diseases caused by various types of bacteria. In this case, there is a varying degree of intestinal damage.In most cases, the first symptoms of intestinal infections are diarrhea, nausea, abdominal pain, fever and vomiting.

The main source of dangerous bacteria and parasites is contaminated food and water. In some cases, bacteria that produce toxins and poison the body rather quickly die in the intestines and are naturally eliminated from it. Then food poisoning, although it occurs, passes rather quickly. If bacteria continue to multiply actively, releasing poisons in large quantities and damaging the intestinal walls, then an intestinal infection occurs.

It is impossible to determine the causes of infection either independently or by visual examination by a specialist. Only laboratory analysis can determine the strain of the bacterium. The earlier the treatment begins, the sooner the condition will be alleviated.

Before starting treatment for an intestinal infection, it is important to establish the cause of the disease in order to exclude the likelihood of poisoning of a non-infectious nature (for example, poisonous mushrooms or berries, pesticides, household chemicals).Therefore, it is important to remember what the patient and his family ate, what kind of water he drank, whether he took medicine, whether he came into contact with any chemicals. In the case of an intestinal infection and poisoning with toxic products, the symptoms will be similar: nausea, chills, weakness, vomiting, abdominal pain, diarrhea, blood in the stool. In case of infection, the body temperature rises, while in case of poisoning, it usually remains normal.

Intestinal infections are both relatively harmless and deadly.In the first case, the body’s immunity is able to overcome bacteria on its own, subject to diet and bed rest. However, an acute intestinal infection can develop rapidly, poisoning the body and destroying its tissues, and in such a situation, powerful antibiotics cannot be avoided. Most often, an intestinal infection is provoked by dairy products that were stored in violation of the temperature regime, and food containing raw or half-raw eggs and meat, seafood and fish. Ready meals (soups, cereals and other side dishes) become dangerous after 12 hours if stored at room temperature.it is necessary to keep food in the refrigerator, which is regularly washed and disinfected. Each product must be individually wrapped to prevent mixing odors and contamination of the refrigerator.

Sausage, ham, smoked meats, even if stored correctly, can lead to intestinal infection. If the food has an unpleasant odor, even a mild one, traces of mold, bubbles or foam, plaque, a strange taste (for example, there is bitterness or signs of fermentation), in no case should it be eaten.You need to rinse your mouth thoroughly, take activated charcoal. You cannot eat canned food if the lid of the jar is swollen or gas is released when opening. Typically, to get an intestinal infection, you need to eat enough spoiled food: a small piece is not dangerous to health, but some microbes, such as botulism or salmonella, can cause infection even if the food is spat out. natural fruits and vegetables stored in a cool place retain vitamins and look appetizing.

To minimize the risk of contamination with pathogenic microbes, you need to make it a habit to thoroughly wash your hands regularly throughout the day and properly handle and store food.

Cooked food must be put into the refrigerator immediately after cooling; food must not be defrosted at room temperature. It is better to refuse the use of eggs, seafood and fish that have not undergone heat treatment.

Fruits, vegetables, berries, mushrooms and herbs should be thoroughly washed with plenty of warm running water and wiped dry with a clean cloth.Dairy products are best consumed immediately after opening the package, monitor the shelf life and storage conditions. Even if there are little signs that food is spoiled, it is best to throw it away. In no case should you consume canned food purchased from your hands. Water, if in doubt, must be boiled. When traveling to exotic countries, you can only drink well-known bottled water. For pregnant women, prevention of poisoning and infections is especially important. It is advisable to restrain your gastronomic whims: for example, some during pregnancy want to eat raw minced meat or exotic fruits.Children should be taught from an early age to wash their hands after using the toilet, when returning from the street, with visible contamination and every time before eating. The child needs to form a habit of washing fruits, vegetables, berries, herbs before eating.

It is important that children understand that food cannot be taken from strangers, parents must control any gifts and edible gifts brought by guests.

Observe the rules of personal hygiene and be healthy!

90,000 Pulmonary and extrapulmonary tuberculosis – Ravijuhend

This patient guide is based on the Estonian treatment guide “Management of patients with pulmonary and extrapulmonary tuberculosis” prepared in 2017 and the topics presented therein together with recommendations.In this manual, you will find the recommendations that are most important from the patient’s point of view. The guide provides an overview of the main problems associated with the disease.

The manual is intended for people with tuberculosis, as well as for their relatives and health care workers. This guide will help patients and their loved ones cope better with their illness, provide answers to the most frequently asked questions about treatment and daily problems, and can support patients and their loved ones during the treatment process.The Patient Guide provides an overview of tuberculosis as a disease, the tests used for diagnosis, treatment, and the organization of a daily regimen during a controlled treatment process.

The guidelines were compiled by experts in the field, along with former patients who have previously experienced and recovered from tuberculosis. The importance of the topics described in the manual and the clarity of the text were appreciated by TB patients and their families. Patient feedback and feedback has been instrumental in the development of this manual and has helped to improve it.

You can learn more about the topics covered in this patient guide by following the links at the end of the guide.

Tuberculosis is an infectious disease that occurs due to a bacterium called Mycobacterium tuberculosis .The causative agents of tuberculosis are spread by airborne droplets. When a tuberculosis patient coughs, sneezes, singing or talking, together with droplets of saliva, tuberculosis pathogens are thrown into the air, which can be inhaled by other people nearby. As a result, a person can become infected with tuberculosis. One untreated TB patient can infect up to 10-15 people a year.

Not all people who have come into contact with an infectious (ie contagious) TB patient can develop TB.The more tuberculosis pathogens are thrown into the air by the carrier of the disease and the denser and longer contact with him, the more the likelihood of the spread of tuberculosis increases. Of all those who have close contact with an infectious TB patient (family members, friends and colleagues who are with the patient every day), approximately one third will become infected. Tuberculosis cannot be contracted, for example, by shaking hands, using the same dishes or the same toilet room.

Tuberculosis can damage all organs of a person, but most often the lungs are the focus of the disease.Of other organs, the disease can most often affect the pleura of the lungs, bones and joints, as well as the kidneys. This form of tuberculosis, in which the lungs themselves are not damaged, is called extrapulmonary tuberculosis, and patients with this disease are usually not contagious. At the same time, in the case of patients with extrapulmonary tuberculosis, it is very important to adhere to the prescribed course of treatment and bring treatment to the end.

All people can become infected with TB, regardless of their financial income or social status.Thus, the assumption that TB only affects people with a low standard of living is incorrect.

In 2016, 190 patients were diagnosed with tuberculosis in Estonia, of which 166 contracted tuberculosis for the first time. In 31 patients, tuberculosis was found not only in the lungs, but also in other organs. Extrapulmonary tuberculosis alone was diagnosed in 15 patients in 2016. Children rarely get sick in Estonia; up to 10 cases of the disease are diagnosed a year.

In case of infection (infection) with tuberculosis, viable but inactive tuberculosis bacteria enter the human body. In most cases, the body’s protective immune system is able to prevent the spread of bacteria in the body. People who become infected with tuberculosis feel healthy, have no symptoms of the disease, and do not spread tuberculosis to others.Infection with tuberculosis can be diagnosed with a blood test (determination of the level of interferon gamma of the causative agent of tuberculosis M. tuberculosis in the blood) or with a tuberculin test (tuberculin test).

The risk of contracting tuberculosis after infection is approximately 5–15%. The risk of getting sick is highest precisely within two years after infection, but you can get sick many years later if, for any reason, the person’s immune system weakened and can no longer keep the multiplication of tuberculosis bacteria.Therefore, it is very important that people who have become infected with tuberculosis know how to track their symptoms characteristic of tuberculosis and, if they are found, immediately go to a doctor.

In some cases, a person who has become infected with tuberculosis is prescribed preventive treatment in order to prevent the further process of becoming ill with tuberculosis. Preventive treatment most often involves one anti-TB drug and treatment lasts six to nine months.

Tuberculosis can be contracted both immediately after infection and several years later.In a disease, the general condition of the human body plays an important role – malnutrition, mental stress, alcoholism, drug addiction, chronic diseases, and immune deficiency (including HIV infection) contribute to the disease. If the immune system of a person infected with tuberculosis is significantly weakened (for example, due to infection with HIV or another disease), then the viable tuberculosis bacteria in the body will begin to multiply and become the cause of tuberculosis. In the case of tuberculosis, the person develops characteristic symptoms and the person can spread the tuberculosis bacteria to others.

The risk of contracting tuberculosis after infection is higher in the following cases:

• in HIV-infected people
• in people with a transplanted organ or in people waiting for a transplant
• in people with chronic renal failure who are receiving dialysis treatment
• in people with silicosis (a rare lung disease that occurs when silica is inhaled)
• for diabetics
• in people taking certain type of biological medications
• in persons in close contact with infectious people with tuberculosis

In case of tuberculosis, the type of symptoms depends on which organ was affected by the tuberculosis bacteria.

If the lungs are affected, the following symptoms may appear:

• cough lasting more than two weeks
• expectoration with purulent sputum or blood
• chest pain

The following symptoms may often occur:

• weakness, feeling of exhaustion
• decreased appetite and body weight
• temperature rise
• increased sweating at night, chills

Photo: Scanpix

Sometimes TB can be asymptomatic.

In case of symptoms characteristic of tuberculosis, you should immediately contact your family doctor or pulmonologist. In case of suspicion of tuberculosis, you can go directly to the pulmonologist dealing with tuberculosis without asking for a referral from your family doctor. Tuberculosis screening tests are also free of charge for those without health insurance.

If tuberculosis is suspected in a child, then for the next examinations you need to consult a doctor dealing with infectious diseases of children.

If there is a suspicion of pulmonary tuberculosis, the doctor should ask the person about the symptoms of the disease and check if there have been any previous contacts with tuberculosis patients.Most often, X-rays are taken afterwards and at least two sputum samples are taken at different times. These sputum samples are sent for examination to detect the appearance of tuberculosis bacteria. In the event that a person cannot give a sputum test himself, expectoration can be caused (provoked) and for this inhalation with saline is done. Another option is to refer the person for a bronchoscopy or for a bronchial tract viewing procedure. Since young children do not know how to take a sputum test, instead of sputum, the fluid obtained after rinsing the stomach is examined.

Photo: Scanpix

A sputum test is primarily examined under a microscope. If during examination under a microscope (so-called microscopy) tuberculosis bacteria are found in the sputum, this means that there is an extensive secretion of bacteria and such a patient can be considered infectious. The attending physician can receive the results of microscopy the very next day after the tests. The sputum is then examined using the culture method, and it can take up to eight weeks to obtain the results of such an examination.The inoculation method can be used to definitively confirm the presence of tuberculosis bacteria if the excretion of bacteria was small. A patient in whom tuberculosis bacteria are found in sputum only using the culture method can also be infectious and infect others with tuberculosis bacteria.

In general, such patients are considered less infectious than those patients in whom tuberculosis bacteria are found in sputum immediately, upon the first examination under a microscope.Searching for tuberculosis bacteria in sputum using the culture method will help to finally confirm the diagnosis of tuberculosis. The inoculation method also determines the drug resistance of tuberculosis bacteria, and this will be the basis for drawing up a treatment regimen.

When diagnosing tuberculosis, rapid tests are also used, the results of which are clarified within a few days. Since it is impossible to determine the sensitivity of the tuberculosis pathogen to all drugs used in treatment with the help of express tests, an examination with a microscope and a seeding method is carried out in parallel.

In case of suspicion of tuberculosis, blood tests are also checked, sometimes computed tomography is done to assess more accurately the damage to the lungs or other organs, and its volume.

In Estonia, in case of suspected tuberculosis, all examinations are free of charge, regardless of the availability of health insurance.

If the tuberculosis bacterium is susceptible to the main drug against tuberculosis (that is, the drug destroys the bacterium), then the course of treatment lasts from six to nine months and treatment is started simultaneously with four to five different drugs. Most often, drugs are used in the form of tablets, but at the beginning of treatment, an injectable drug may also be present in the regimen. With proper medication, your doctor may reduce your daily medication after two or three months.

In case of drug sensitivity, the main drugs are:

• isoniazid
• rifampicin
• ethambutol
• pyrazinamide
• streptomycin

Photo: Scanpix

Tuberculosis is almost always curable, but for a full recovery, you must strictly follow the course of treatment prescribed by your doctor. The well-being of a patient with a drug-sensitive tuberculosis pathogen usually improves after a few weeks after starting treatment.Often during this period, a person is no longer infectious. Still, it is very important to remember that the multiplying pathogens of tuberculosis persist for some time in the body, even when the patient no longer has any problems and does not feel sick anymore. Therefore, for complete recovery, strict adherence to the tuberculosis treatment regimen is necessary throughout the entire period of treatment.

Untreated tuberculosis is still dangerous for people around, and especially for children and those with weakened immunity.

If the causative agent of tuberculosis cannot be destroyed with any specific drug, then this means that the bacterium is not sensitive to the drug, i.e.that is, it is resistant. If the causative agent of tuberculosis is resistant to the main two drugs for tuberculosis – isoniazid and rifampicin, then this form of the disease is called multidrug-resistant tuberculosis. Treatment for MDR-TB is more difficult and takes significantly longer than for drug-sensitive TB (one and a half to two years).

A person can become ill with drug-resistant tuberculosis in two ways:

• already initially infected with drug-resistant bacteria
• Drug resistance can develop during treatment when a patient does not take the prescribed drugs in the correct amount, with the necessary frequency, and for a long time.

Five to seven drugs are used at the same time to treat MDR TB, and these drugs can cause more side effects.

In 2016, MDR TB was diagnosed in 24 patients in Estonia, of whom 17 contracted TB for the first time.

In the process of treating tuberculosis, the so-called Directly Observed Treatment (DOT) is used. DOT means that the patient must take the medication every day in the presence of the nurse, who directly checks if the medication has been taken.Usually tuberculosis treatment begins in the hospital, but after the infectious period passes, treatment can be continued on an outpatient basis, i.e. at home.

Photo: Scanpix

DOT is trying to make it as convenient and accessible for the patient as possible. For example, a patient can be compensated for by public transport to the hospital to receive medication. If the patient is allowed home treatment, but he cannot come to the nurse who monitors the treatment of tuberculosis, then the medicine is brought to the patient’s home.In the last months of the course of treatment, when the patient feels well and is no longer infectious, he can return to work or school and lead a normal life.

During treatment, the pulmonologist constantly monitors the patient’s course of treatment and the recovery process. To do this, new examinations of the composition of sputum are carried out every month, X-rays are repeated and, if necessary, blood tests are done.

Tuberculosis is a particularly dangerous infectious disease, which is dangerous both for the patient himself and for those around him.Based on this, those who refuse tuberculosis treatment or interrupt the course of treatment in Estonia can be sent for compulsory treatment for up to six months (182 days) to the Jamejala Tuberculosis Treatment Unit in Viljandi hospitals.

Tuberculosis medications can cause side effects. It is important that the patient monitors the occurrence of side effects during treatment and immediately informs the attending physician about them.Medicines for the treatment of side effects are provided by the attending physician to patients free of charge. Certain vitamins are given along with TB medicines to reduce the risk of side effects.

Lifestyle during TB treatment

If the patient has been transferred to outpatient treatment, then he can lead a normal life, leave the house and communicate with friends and acquaintances.It is important to adhere to the prescribed treatment regimen and the principles of a healthy diet. For a better course of the treatment process, it is advisable to give up unhealthy habits, such as drinking alcohol and cigarettes.

If the patient is no longer infectious, has no symptoms of the disease and the drugs do not cause side effects, then he can return to work or school and during treatment for tuberculosis. It is important to remember that it is imperative that the patient continue to receive DOT visits when returning to work or school.Therefore, during treatment of tuberculosis, in general, the patient cannot leave for a long time from the place of treatment.

If the patient is not able to work during the treatment, then a certificate of incapacity for work is issued for him for this period. Compensation for the certificate of incapacity for work can be obtained in 240 calendar days and, if necessary, at the end of this period, you can apply for the appointment of a status of incapacity for work. To do this, you must submit an application for an assessment of the work ability to the unemployment fund.A patient attending a high school can apply for a sabbatical leave for the duration of the treatment.

Photo: Scanpix

During TB treatment:

• smoking impairs the protective functions of the lungs and therefore slows down recovery 90 150
• Drinking alcohol during treatment can cause serious side effects
• after the period of infectious danger has passed, it is possible to restore sexual activity
• pregnancy during this period is not advisable and you should take into account that anti-tuberculosis medications can weaken the effects of contraception.
• tanning in the sun and in tanning salons should be avoided, as the side effects of drugs may cause age spots and increase the risk of sunburn
• Saunas are not prohibited, but very hot steam is contraindicated.
• All foods can be eaten, good nutrition helps the healing process 90 150

Case management after tuberculosis treatment

A patient who has suffered tuberculosis caused by a tuberculosis agent that is sensitive to treatment, has completed the full cycle of treatment prescribed by the attending physician, and recovered, does not need regular medical supervision after recovery.And yet it is very important that this patient knows how to monitor his own health and in case of symptoms of tuberculosis, he must turn to a pulmonologist or family doctor.

A patient who has had multidrug-resistant tuberculosis, who has HIV and does not adhere to the exact prescribed medication regimen, after recovery should be followed up for two years with a frequency of every six months. For observation, the patient must visit a pulmonologist and during each visit he will be asked questions about possible symptoms, take X-rays and check the sputum for the content of tuberculosis bacteria.

Photo: Scanpix

A patient with tuberculosis can protect their loved ones from the danger of infection if he:

• Takes tuberculosis medication strictly as prescribed by a doctor
• when coughing, turns his head away and covers his mouth with his hand or paper towel
• will ask all persons in contact with him to see a doctor for a health check

In the case of each patient, the circle of close contacts with him is found out, for whom the risk of infection is very high.To do this, the nurse observing a patient with tuberculosis asks him about those contacts who may be infected and who have a high risk of also contracting tuberculosis. Finding out who was in contact allows you to call people at risk for a medical examination and detect new cases of tuberculosis as early as possible.

If the patient himself does not want to inform his contacts about his disease, then this can be done by a medical officer. Informing the contact persons and inviting them to the examination should be delicate, and at the same time the name of the sick patient should not be mentioned.Both for the patient himself and for all persons in contact, all examinations related to tuberculosis are carried out free of charge, regardless of whether the person has health insurance. You do not need a referral from a family doctor for the examination.

For most people in contact, X-rays are taken and a blood test (determined by the level of interferon gamma M. tuberculosis) or a test for tuberculin. Sometimes a sputum composition is examined.

In some cases, prophylactic treatment is prescribed for persons who have come into contact with a patient with a drug-sensitive pathogen of tuberculosis, in whom tuberculosis infection was detected.The goal of preventive treatment is to prevent tuberculosis. During preventive treatment, you need to take one essential TB drug almost every day for six to nine months. Before prophylactic treatment is prescribed, tests are always carried out to prevent tuberculosis.

Preventive treatment is prescribed, if necessary, after infection with tuberculosis:

• mothers of children under 5 years old
• for HIV-infected people in contact
• people taking a certain type of biological medicine
• people whose immune system is weakened due to any disease or its treatment
• people with a transplanted organ or people who are in the waiting list for a transplant

Those who have come into contact with a patient with multidrug-resistant tuberculosis and who are infected as a result are not prescribed prophylactic treatment, since effective treatment regimens have not yet been developed for this case.To observe them, X-rays are taken every two years. Also, all persons who have been in contact with a patient with multidrug-resistant tuberculosis are trained to monitor their symptoms of tuberculosis.

1. Ai J-W, Ruan Q-L, Liu Q-H, Zhang W-H. Updates on the risk factors for latent tuberculosis reactivation and their managements. Emerg Microbes Infect. 2016 Feb; 5 (2): e10.
2. Landry J, Menzies D.Preventive chemotherapy. Where has it got us? Where to go next? Int J Tuberc Lung Dis Off J Int Union Tuberc Lung Dis. 2008 Dec; 12 (12): 1352–64.
3. Malaysia Health Technology Assessment Section Ministry of Health Malaysia. Management of Tuberculosis (3rd Edition). 2012.
4. Ministry of Science and Innovation, Spain. Clinical Practice Guideline on the Diagnosis, Treatment and Prevention of Tuberculosis. 2010.
5. National Institute for Health and Care Excellence.Tuberculosis. 2016.
6. Public Health Agency of Canada. Canadian Tuberculosis Standards 7th Edition. 2014.
7. TB CARE I. International Standards for Tuberculosis Care, Edition 3. The Hague: TB CARE I; 2014.
8. Viiklepp, P. Tuberkuloosihaigestumus Eestis 2012-2013. Tallinn: Tervise Arengu Instituut; 2014 90 150
9. World Health Organization. Global Tuberculosis Report 2016. Geneva: World Health Organization.
10. World Health Organization.Systematic screening for active tuberculosis: principles and recommendations. 2013.

1. On the Health Information Portal
2. On the website of the Finnish Lung Health Society
3. On the medical portal inimene.ee
4. On the medical portal kliinik.ee
5. On the portal of the Institute for Health Development hiv.ee
6. Information brochures on tuberculosis published by the Institute for Health Development

Nutritional recommendations can be found on the website of the Institute for Health Development www.toitumine.ee.

Medical institutions that can be contacted in case of suspected tuberculosis

You do not need to ask your family doctor for referrals to receive an examination, and all examinations related to the detection of tuberculosis are free for those patients who do not have health insurance.

Tallinn
Polyclinic for tuberculosis treatment at the Pulmonary Center of the North Estonia Regional Hospital
Hiiu 39, Tallinn
Reception of adults and children – patients from Tallinn, Harju and Raplamaa.
Reception phone 617 2929
Children’s office – phone 617 2951

Tartu
Adults admission – patients from Tartu, Tartu County, Jõgeva County, Valga County, Põlvamaa
Polyclinic for Lung Diseases of the University of Tartu Clinic, Riia 167, Tartu
Pulmonologist’s office – phone 731 8949
Reception of children – patients from Tartu, Tartu County, Võrumaa, Jõgevamaa, Valgamaa, Põlvamaa
Children’s Clinic of the University of Tartu Clinic, Lunini 6, Tartu
Children’s office in Tartu – phone 731 9531

Jõgeva
Jõgeva Hospital, Piiri 2, Jõgeva
Reception phone 776 6220

Kohtla-Jarve
Polyclinic Ida-Viru Central Hospital, Ravi 10d, Kohtla-Jarve
Reception phone number 339 5057, 331 1133

Narva
Narva Hospital Infectious Diseases Department, Haigla 5, Narva
Reception phone 357 2778
Pulmonologist’s office – phone 354 7900

Haapsalu
Läänema Hospital, Vaba 6, Haapsalu
Reception phone number 72 5800,
Pulmonologist’s office – phone – 472 5855

Kuressaare
Kuressaare Hospital, Aia 25, Kuressaare
Reception phone number 452 0115

Paide
Järvama Hospital, Tiigi 8, Paide
Reception phone 384 8132
Pulmonologist’s office – phone 384 8117

Polva
Põlva Hospital, Uus 2, Põlva
Registry phone 799 9199

Pärnu
Pärnu Hospital, Ristiku 1, Pärnu
Reception phone 447 3300
Pulmonologist’s office – phone 447 3382

Rakvere
Rakvere Hospital, Lõuna Põik 1, Rakvere
Reception phone 322 9780
Pulmonologist’s office – phone 327 0188

Viljandi
Viljandi Hospital, Pärsti Rural Municipality, Viljandi County
Reception phone 434 3001
Pulmonologist’s office – phone 435 2053

Voru
South Estonian Hospital, Meegomäe village, Võru parish
Reception phone 786 8569
Pulmonologist’s office – phone 786 8591

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