Pelvic pain is generally referred to as the pain in the lower abdominal region. Pelvic pain might be acute, sudden, or chronic, recurrent, cyclical in nature. It may present as central or lateralized pain and might spread to the thighs and buttocks. Pelvic pain might be an indication that something is wrong with the internal reproductive organs located in the pelvic region such as ovaries, fallopian tube, uterus and vagina in which case occurrence of pain may be related to particular time in menstrual cycle.

Pelvic pain can be indicative of a pelvic infection or related to the pelvic bones/spine problems.

Also it may indicate that there is something wrong with the digestive system or urinary system.

Causes-

The causes are as follows:

Pelvic pain occurs commonly in disorders of the internal reproductive organs such as ovarian cysts or pelvic inflammatory disease (where in sexually transmitted bacteria spread through the reproductive organs and cause infection) or pain during ovulation.

Pelvic pain might also occur due to endometriosis (a form of disorder where the endometrial tissues that are located inside the uterus tend to grow outside the uterus resulting in severe pain), adenomyosis (a disorder wherein the endometrial tissues which line the wall of the uterus tend to grow within the uterus), , pelvic adhesions or ectopic pregnancy (when the fertilized egg gets inserted somewhere else other than the main uterine cavity),

Pelvic pain can occur due to bladder disorders, kidney stones, infection in the urinary tract, constipation, flatulence,inflammatory bowel disease, irritable bowel syndrome and chronic hernia.

It can also be a symptom in some cancers such as ovarian cancer, colonic cancer, advanced ovarian , endometrial and cervical cancer.

The following symptoms might occur along with pelvic pain:

Sustained pain in the hips and the groin

Sudden fever

Severe pain while urinating , passing stools or during sexual intercourse (dysparuenia)

Vaginal bleeding or vaginal discharge .

Blood in stool

Severe menstrual pain ( dysmenorrhoea)

Repeated instances of constipation or diarrhoea

Increase In pain with stress and physical movements

Investigations-

The Gynaecologist will do physical examination including bimanual internal examination. Also, complete blood count, urine for microscopy, vaginal swabs if discharge, stool examination. Ultrasound examination of the pelvis is an important investigation.

Treatment-

If the pain is gynaecological and depending on the cause doctors might suggest different therapies. In cases where pain is due to an ovarian cyst or endometriosis, doctors may prescribe birth-control pills. In cases of suspected pelvic infection, antibiotics are prescribed. Also, laparoscopic surgery might be advised in cases of acute pain due to cyst, endometriosis, or pelvic adhesions: for confirmation of diagnosis and excision or removal of cysts and endometriotic implants and division of adhesions respectively. In some cases of chronic pain, the gynaecologist may manage the case with inputs from gastroenterologist and pain consultant.

Causes and Symptoms of Pelvic Pain

Low levels of testosterone can end up affecting various aspects of a your life. It can affect your libido, your performance in bed along with your motivation and energy. Testosterone replacement therapy can bring the levels back to what they were before and restore his lost confidence, energy and vigour.

Testosterone is a hormone which is mainly produced in the testicles. Testosterone controls bone density, distribution of fat, muscle mass and strength, body and facial hair, red blood cell production, sex drive and production of sperms.

Testosterone levels generally lower with age, especially after 30. Usually, in older men, low levels of testosterone result in androgen deficiency. Androgen deficiency affects the muscle mass, bone density, weight and can drastically change sleep patterns as well. On the other hand, testicle injury, testicular cancer or treatment for it, hormonal disorders, infections, HIV/AIDS, chronic kidney or liver disease, type 2 diabetes and obesity can lead to low testosterone levels as well.

While testosterone replacement therapy (TRT) seems very desirable, there are certain risks and benefits which need to be considered.

Factors to be considered before opting for it

1. Sleep apnea is one of the risk factors of TRT. In this condition, breathing stops and starts repeatedly when you sleep.

2. Acne problems and other skin disorders

3. Swollen breasts. Men with breast cancer should not opt for this treatment.

4. TRT can trigger noncancerous prostate growth.

5. Sperm production is limited or the testicles might shrink

6. Chances of deep vein thrombosis (blood clots in veins) leading to pulmonary embolism (clots burst and lodge into your lungs) are increased.

Benefits of getting a testosterone therapy done

1. Sexual drive, performance and function are improved.

2. Mineral density of the bones gets restored

3. Healthy weight loss, thus improving your body composition

4. Muscle strength and mass improves

5. Mood and energy gets a boost

6. Cognitive functions improve

7. Lessens the risks of type 2 diabetes and cardiovascular diseases

8. Improves metabolism

9. Reduces chances of anaemia or improves the condition if you are already suffering from it

Risks and Benefits of Testosterone Therapy

One of the most debilitating conditions that anyone can experience is migraine. They can severely limit you by affecting your personal and professional life as you are in constant pain. Migraine can manifest in a type of headache with intense pain, an acute sensitivity to light, vomiting and nausea. Often described as a severe throbbing pain in the head, it may stop you from completing regular daily tasks and may delay or postpone your work.

How can migraines be treated?
The exact cause for these debilitating migraine pain hasn't been pointed out yet, but certain triggers such as stress, hormonal changes in the menstrual cycle, sun exposure, bright or flashing lights, among many others have been identified. The first line of defense for you would be to understand and identify what your triggers are. Once that is done, you can try and avoid them. If these still trigger a migraine or are about to trigger one, you can immediately take medications or steps to control it or at least lessen the pain to go through your day. Some of the options you can employ to this effect are mentioned below.

Medications to prevent a migraine attack: The medications mentioned here are specialized treatments and can only be taken after a consultation with a doctor. If you are deemed as a candidate for preventative medication for migraines, then either one or a combination of drugs from the following may be prescribed to you.
Valproate and Topiramate are anti-seizure medications which can be used to prevent migraines.
Propranolol, a type of beta blocker and used for cardio vascular problems, has proven to be very effective in preventing migraines.
Onabotulinumtoxin A or a type of Botox, has shown a lot of promise in preventing migraines and is being slowly rolled out as a proper drug as a treatment option.
Certain antidepressants have also shown to be quite effective in reducing the symptoms of migraines as well.
Medications to relieve pain: Some of the go to medications that help relieve your pain from migraine are mentioned below. Although some of them are OTC (over the counter) drugs, it is best advised that you consult with your doctor for medications which suit you better. The side effects of these medications can be bad and thus, it is not advised to continue them in the long run and to find other means to control pain from migraines. Some of the medications to relieve pain temporarily are:
Triptan is a drug used to treat severe migraines
Caffeine along with Ergotamine can also help dull the pain and deal with it.
Ibuprofen and aspirin and Acetaminophen are common pain killers that you can use
Codeine, which contains opioids are also used to treat this problem.
Metoclopramide and chlorpromazine are two examples of anti-nausea medications as vomiting along with nausea may frequently accompany your migraine.
Always remember that these medications can have strong side effects if not taken properly, therefore do not just pop a pill, consult your physician first and know which one should you take and how frequently. 

Severe Headache - Can it Be Migraine?

Restless leg syndrome is a condition where the nervous supply to the lower legs (and sometimes hands) is affected. The person has a constant urge to move the legs due to the tingly sensation or the pins and needles sensation and so this condition is called as restless legs syndrome (RLS). It is almost never a standalone condition and is often associated with other nervous system conditions.
It is a progressive condition and aggravates with time. The patient may experience episodes of this disease. Most people might experience this problem at night due to which a lot of patients complain of disturbed sleep and restlessness while sleeping.

While there is no permanent solution to this condition, there are various home remedies and techniques which can help control the condition. Read on to know more.

Trigger agents: Some people are able to identify triggers like caffeine or chocolate which induce the condition. The first step would then be to avoid using these, especially before sleeping.
Exercise: Any form of exercise, which gives a good workout for the leg muscles is recommended. This could range from a 30-minute brisk walk to stretches depending on the person s overall health status. This is known to induce a good sleep, reduce muscle tension and relax the mood. Choose yoga, gym, cycling, or any form which suits your overall health and schedule.
Massages:Hot or cold massages, often used alternately, can help in relaxing the muscles. This also helps in reducing tension and improving overall sleep. The ideal time for the massage is the evening so that RLS does not affect during nighttime.
Diet: A diet rich in vitamins and minerals can prove to be helpful. This is because proper muscle and nerve function requires various minerals like zinc, potassium, calcium, sodium, etc. Diet rich in these helps in improving muscle and nerve function and thereby control RLS.
Sleep pattern: Sound sleep practices like having an early dinner, a quiet room free of digital media, optimal temperature, and relaxing ambience helps in a better sleep. This has shown to reduce the incidence of RLS and evidence of sound sleep.
Medications: RLS can also cause mild to moderate pain in the affected legs, and so pain killers can be used once in a while if the pain is not bearable. These should be used only rarely and continued use can lead to stomach ulcers and bleeding. The above mentioned nonmedical methods should be tried before trying medications. Anticonvulsants have been used to control RLS if pain killers alone are not adequate. In more severe cases, antiparkinson drugs are used with great success.

Restless Leg Syndrome - How It Can Be Controlled?

Foods to eat/ avoid for arthritis and inflammatory pain

Different foods have different properties. Here are some foods to have and a few you must refrain from if you are suffering from arthritis and inflammatory pain:

Include these foods in your diet.
1) cherries - these contain anthocyanocides which assist in lowering uric acids, thus reducing the level of pain.
2) ginger - eating fresh ginger of drinking ginger root tea is advisable if suffering from arthritis and inflammatory pain. The gingerols present in it include anti-inflammatory compounds which are extremely helpful.
3) pineapple - there exists in pineapples, an element called bromelain which is a very effective anti-inflammatory.
4) raw apple cider vinegar - anti-inflammatory properties of raw apple cider vinegar are also very beneficial. It can be consumed by drinking a tablespoon of the vinegar mixed in about 250ml water or as salad dressing.
5) turmeric - turmeric or as we call it haldi, has anti-oxidant as well as anti-inflammatory properties.
6) omega 3 fatty acids - omega 3 fatty acids also have anthocyanocides. Which lower the levels of uric acids. Eating more of chia seeds, flax seeds and fish is also encouraged.

And the foods to avoid are,
1) sugary foods - sugary foods are like toxins which cause inflammations and lead to more pains in the body. Hence, avoid foods with excessive sugar when suffering from arthritis and inflammatory pain.
2) omega 6 oils - these oils, if consumed in high amounts, cause inflammations. It is advisable to replace these foods with healthier foods.
3) fried foods: deep fried foods are cooked at high temperatures and thus induce inflammation.
4) salt - this happens to some people where excess intake of sodium increases the pain in the joints. Hence, lowering consumption is not a bad idea.



Living With Arthritis - Foods To Pick OR Kick

A Gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver. If you are planning to visit one, you most likely have a problem in one or many organs like esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. 

Visit your doctor to understand the severity of your condition and the course of treatment, as it is obvious that during this time you must be suffering from anxiety and you may not ask the questions arising in your mind. That is why you need to prepare in advance for your first visit with a gastroenterologist. Being an active partner in the doctor patient relationship is bound to have its benefits. Here are some handy tips:

1. Come mentally prepared: Don't let the anxiety get to you. If you need some extra help calming down, try yoga or meditation. You can simply go out on a walk alone to help you focus your thoughts. This is just like any other doctor visit. The good part is that you are taking the first step in easing your discomfort and starting treatment, so go with a positive mind.

2. Maintain a diary of symptoms: It is likely that you are experiencing discomfort from past few days or weeks before you finally realize the need to seek out a specialist. Try to remember as much as possible about the symptoms you experienced in a chronological order. Write down any over the counter medicines you've tried or anything unusual that you may have consumed in the past week. 

3. Take stock of your medical history: It is likely that your doctor may want to know about any historic conditions you've suffered that may or may not relate to your present condition. Many ask you to fill out forms during your first time patient registration which includes many minor details about your medical past. List down any allergies, especially food allergies you have. 

4. Take stock of your recent medical tests: Bring your latest blood tests and imaging tests (X-rays, ultrasounds, MRIs, and CT scans) with you for the doctor's visit. If you have a pre-existing condition like diabetes, thyroid or you suffer from other chronic conditions like increased uric acid, carry your most recent medical reports with you. 

5. Make a list of questions for the doctor: In most cases, the first visit is a crucial factor in determining whether you want to continue the course of treatment with a particular doctor. This comes out of your ability to trust the doctor, his knowledge and diagnosis and an overall comfort level that comes with how well he handles your questions. Start by making a list of questions you want to ask about your specific condition and course of treatment and see if you get satisfactory answers. 

6. Brace yourself: If you want to suggest a treatment option, make sure you read up all about it before you tell the doctor.

6 Tips For Your First Visit With A Gastroenterologist

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