Renal Tubular Acidosis is a medical condition. When the kidney is unable to acidify urine, it leads to the accumulation of acid in the body. Usually, when blood is filtered by the kidney, it passes through the tubules of the nephrons (the functional unit of the kidney).

Before it flows into the bladder from the kidney, the urine undergoes an exchange of salts, acids and other solutes. Renal tubular acidosis results in the formation of excessive amounts of acid because the kidneys cannot drain them. This may happen because the kidneys cannot reabsorb the alkaline bicarbonate ions from the urine in the early segment of the nephron or because of inadequate production of acidic hydrogen ions in the latter half of the nephron.

Renal Tubular Acidosis is simply associated with abnormal urinary acidification. Other functions of the kidneys remain unimpaired.
There are several different types of renal tubular acidosis-

  Distal Renal Tubular Acidosis (RTA)
This is the most fundamental form of RTA. It is characterized when the hydrogen ions are not secreted into the lumen of the nephron by the alpha-intercalated cells of the medullary collective duct of the distal nephron. When this happens the pH of urine cannot be brought down below 5.3. Renal excretion is inhibited and hydrogen ions are not eliminated which leads to academia. At the same time, Potassium ions cannot be absorbed by the cell which leads to hypokalemia. The end result is protein retention and potassium excretion. Distal RTA can lead to the urinary stone formation, calcium deposits in the kidney, rickets and osteomalacia and Sjogren s syndrome.

  Proximal RTA
When proximal tubular cells reabsorb 85% of filtered bicarbonates and 60% of filtered sodium from the urine, then this again leads to academia. The distal intercalated cells, however, function normally and so the academia is not as severe as in case of Distal RTA. The alpha-intercalated cells can acidify urine to a pH of 5.3 or less because they produce hydrogen ions. Proximal RTA is also associated with Fanconi Syndrome which is characterized by aminoaciduria, uricosuria, glucosuria, and tubular proteinuria.

  Combined distal and proximal RTA
Inherited carbonic anhydrase II deficit leads to combined distal and proximal RTA. This is accompanied by osteopetrosis, cerebral calcification, and renal tubular acidosis. Cases of combined distal and proximal RTA are very rare.

How is RTA understood?
The following steps are applied to analyze Renal Tubular Acidosis-
  Determining the anion gap in acidosis. The normal Anion Gap is 8-12 (4-6 mEq/L)
  Separating the renal from the extrarenal causes of normal anion gap acidosis
  Classifying the types of RTA
  If it is distal RTA, further tests will be necessary to support the diagnosis

How is RTA diagnosed?
Three types of tests can reveal if a person is affected by Renal Tubular Acidosis-
  Urine test
  Acid load test
  Physical examination

Treatment of RTA-
Doctors prescribe either or both of the following two types of therapies-

  Alkali therapy- The pH level of urine is restored and electrolytes are balanced
  Vitamin D supplements- If RTA leads to bone deformities or rickets, your doctor will prescribe vitamin supplements to strengthen your bones.

Timely diagnosis can prevent the effects of Renal tubular Acidosis from becoming compounded. With the right medication, a person can lead a healthy normal life.

What Should You Know About Renal Tubular Acidosis?

An anal fissure is a small tear or crack in the lining of the anus which causes sharp pain, bleeding, itching, or burning.

An anal fissure can affect people of all ages, and it s often seen in infants and young children. Constipation is a common problem in this age group and it is a major cause of this problem.

An anal fissure usually isn t a serious condition. In most cases, the tear heals on its own within four to six weeks. In cases where the fissure persists beyond eight weeks, it s considered chronic, or long term.

Symptoms-

A visible tear in the skin around the anus
A small lump of skin just next to the tear
A sharp pain in the anal area during bowel movements
Streaks of blood on stools or on wiping
Burning or itching around the anus
Causes-

Straining during childbirth
Straining during bowel movements as a result of constipation
Chronic constipation
Diarrhea
Inflammatory bowel disease (IBD)
Overly tight anal sphincter muscles
In rare cases, an anal fissure may develop due to:

Anal cancer which occurs due mostly to ano-receptive sex without barrier protection
HIV infection
Tuberculosis
Syphilis
Herpes
Let s take a closer look at these risk factors.

Anal fissures are common in infants and young kids. Older adults also become prone to anal fissures as the blood flow to the anorectal region decreases.
Women also become prone to these fissures due to straining during childbirth.
The inflammation that occurs in the intestinal lining in people with IBD makes the tissue around the anus more prone to tearing, further causing fissures.
People who frequently experience constipation are at an increased risk for fissures. Also, one can suffer from fissures due to straining and passing large, hard stools. In both these cases, one may experience tears in the anal lining.
Frequent diarrhea can also tear the skin around the anus and so can ano-receptive sex without protection. This can lead to sexually transmitted diseases like genital herpes, HIV/AIDS and infection with HPV virus which causes anal cancer.
Treatment-

Treatment usually helps control anal fissures and the discomfort it causes. Your doctor will prescribe stool softeners and topical pain relievers to stem discomfort. However, if these do not make your anal fissure go away then surgery may be required. And in addition to this, your doctor will also need to look for other underlying causes that can cause anal fissures like for example anal cancer.

Diagnosis

An anal fissure can be diagnosed by simple physical exam. The doctor looks at the area around your anus and follows it up with a rectal exam to confirm the diagnosis.
This can mean the use of an anoscope. In this, the doctor inserts an anoscope into your rectum to be able to see the anal tear.
An anoscope is a thin tube and it allows doctors to inspect the anal canal. An anoscope is also used to diagnose other causes of anal or rectal pain such as hemorrhoids or piles.

How Anal Fissures are Diagnosed?

An apple a day keeps the doctor away, but Minions seem to disagree. An apple being the fruit of choice for millions of households across the world, recent studies show that apples may not be as good for you as you ve been led to believe. For starters they have high sugar content, for the calorie conscious, which might be a bad revelation. The really high fiber content of apples is known to induce stomach aches. Studies show that most apples in the regular market are laden with pesticides, which are harmful for human consumption. Apples are known to cause allergies too and not to forget, apple seeds contain trace amounts of cyanide.

So if not apples, what is supposed to keep the doctor at bay? The world is going ga ga over bananas. Bananas and papayas are two easy to resource, lower priced alternative as the household fruit of choice. Here s why.

Papayas and Bananas contain fewer carbohydrates and more protein than Apples and hence instantly making them a better choice for calorie conscious.
High levels of Tryptophan, make bananas and papayas a natural antidepressant and stress buster.
Both are rich in Anti oxidants which helps in preventing and fighting cancer.
Bananas protect an individual against type 2 diabetes and aid in weight loss in this new age of morbid obesity that makes it quite a selling point.
Both fruits being rich in vitamin C are known to boost immunity.
Papayas are rich in flavonoids, vitamin A and beta carotene, which protect the mucus membrane of the eye and are known to prevent age related retardation of eye sight.
Bananas and Papayas help prevent swelling of joints and work well to prevent arthritis.
Both fruits are known to help ease menstrual cramps.
Papaya is rich in vitamin E, vitamin C and antioxidants like beta-carotene which helps prevent your skin from free radical damage keeping wrinkles, marks and signs of ageing at bay.
Papaya is known to encourage hair growth and fight against hair fall.
The duo is known to improve overall digestion as well.

Why Is Banana or Papaya Healthier Alternatives for Apple?

The word colic directly refers to the colon. Colic pain is a sharp abdominal pain followed by bouts of crying usually occurring in infants below the age of one year. The pain only last for a short period of time ranging from a few weeks to a couple of months. Very few number of babies will cry endlessly indicating towards an underlying condition.

It is mainly characterized by sharp crying for supposedly no apparent reason, irregular sleep patterns, and restlessness or owing to deviation from normal postures. The apparent causes of colic pain include indigestion and negative reaction of the sensitive gut to the breast or formula milk, although no concrete cause of the state has been discovered.

Doctors often suggest home remedies such as swaddling, pacifiers, holding and comforting the baby and more frequent feedings to reduce the condition. Since it is so common among infants and relatively less harmful, no proper medication is usually given. Physicians suggest mothers to reduce the content of caffeine, alcohol or spice in their diet. Sometimes a warm bath, burping the baby or going on more frequent walks is useful. Background music draws the attention of the baby and hence drives their focus, away from the abdominal pains.

Colic pains are mainly treated by care rather than medicine. The baby is made to feel comfortable and the distress is reduced just by being around the infant. The primary care giver plays an important role in consoling the child and helping them get through the sudden pain which further plays a significant role in personality development. Colic pains are extremely short lived and probably one of the first few challenges of parenthood. They are primarily dealt with care and feeding except in extreme cases where medicinal cures such as lactase drops and simethicone drops are used to treat the abdominal pain.

Colic Pain - How To Treat It

Read to know why choosing diet drinks over regular beverages is not good for your health. The diet contains aspartame which is reportedly 200 times sweeter than table sugar. It adversely effects the brain, increases belly fat, headache, abdominal pain etc. 

Diet Drinks vs. Regular Beverages: Which is Worse For Your Health?

Colorectal cancer is otherwise known as cancer of the colon or the rectum. This can affect both men and women with age being a major risk factor. Majority of such cancers are seen to occur after age of 50 years.

Type: colorectal cancers can present as one of the following types: 

Adenocarcinomas are the most common type of colorectal cancers. These cancers begin in the cells making mucous and other fluids. Certain colorectal cancers begin as adenomatous polyps (adenomas) that turn cancerous over a period of time. This is precisely why the adenomas are regarded as pre-cancerous or pre-malignant.

Gastrointestinal (GI) carcinoid tumors, GI stromal tumors, primary colorectal lymphoma, leiomyosarcoma, melanoma & squamous cell carcinoma are certain other colorectal cancers

Carcinoid tumors: start in specialized cells that produce hormones, in the intestine.

GI Stromal tumors: start in the interstitial cells of Cajal (ICC), in the wall of the colon.

Lymphomas: start typically in the lymph nodes but they may also start in colon or rectum.

Sarcomas: can start in the muscle and the connective tissue in the walls of the colon and rectum.

Gender: it affects both male and female populace.

Etiology: mostly, the factors that are associated with increased risk of colorectal cancer include the following  

Age exceeding 50 years.

Racial & ethnic background such as African Americans, in the USA, are known to have the highest incidence of colorectal cancer, and mortality rates.

Low fibre and high fat diet. Excessive consumption of red meat (e.g. goat meat, beef, pork, lamb, or liver), processed meats, butter, refined grains, sweets, sugary drinks etc all can increase the risk of colorectal cancer.

Personal history of inflammatory bowel disease (IBD) (e.g. ulcerative colitis), Crohn s disease, adenomatous colorectal polyps, colorectal cancer etc all.

Family history of colorectal cancer or adenomatous polyps etc all.

Inherited syndromes such as familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC).

Sedentary lifestyle/ associated Obesity.

Type 2 diabetes.

Tobacco and alcohol abuse.

Features or symptoms can vary from person to person depending on the size and location of the tumour. Following are the signs & symptoms mainly -

Changes in bowel habits, diarrhea or constipation or an alternating diarrhea and constipation.

Occult/ blood in the stool, and 

Problems related to blood loss (e.g. anemia, weakness, fatigue, intolerance to exercise, shortness of breath, increased heart rate, chest pain etc all),

Abdominal discomfort (frequent gas/ flatulence, bloating, fullness, cramps, and pain), vomiting etc.

Unexplained weight loss,

Pain with bowel movement,

Feeling that bowel does not empty completely,

Stools are narrower than usual.

Diagnosis: Following are the diagnostics employed. Abnormal blood test results may be indicative of malignancy, but a follow-up imaging/ biopsy is always the gold standard for accurate diagnosis.
Blood: fecal occult blood test, Carcinoembryonic Antigen (CEA) assay values are raised, Hb/ RBC counts may be low.
Imaging: Colonoscopy, Endorectal Scan/ CT Scan followed by Biopsy clinches the diagnosis and the nature of the disease.
Apart from the above-mentioned barium enema X-Ray, USG, Chest X-ray, PET CT scan etc all help detect metastasis, if any. An increase in level of the serum tumor marker  CEA  is indicative of metastatic spread/ proliferation that can be ascertained through a PET CT scan.
Treatment: Conventional treatment includes surgery, radiation and chemotherapy as contextually appropriate. Simultaneously, an adjunctive/ integrative naturopathic treatment with suitable complementary & alternative medicines (CAM)/ therapies too can help improve clinical outcomes and facilitate recovery as feasible contextually.
Prognosis: preventive measures, earlier diagnosis and right early treatment is key for better prognosis and efficient/ effective therapeutic management. Usually, the chances of cure for an early stage cancer are more. Above-mentioned apart, recovery chances are influenced by the grade, stage of cancer, recurrence and the patient s general health & vitality etc all too.

Prevention: rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for prevention or reducing the risks of colorectal cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Apart from the generic preventive measures as mentioned above, certain pre-malignant conditions, of which adenomas are the most common, can be successfully treated with complementary and alternative medicines too.

Colorectal Cancer - In a Nutshell!

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