The general perception that hereditary diseases cannot be prevented is changing. Polycystic kidney disease (PKD) is one such hereditary condition. The kidneys are the body's detox machine, which remove all impurities and flush it out of the system through urine. PKD is a condition where there are multiple, fluid-filled cysts which develop in the kidneys. These can vary in size and though noncancerous, can grow to a very large extent, producing severe symptoms including extremely high blood pressures and kidney failure.

In the recent past, however, there have been various theories that put forth how a modified and healthy lifestyle can prevent PKD. A child with a parent who suffers from PKD has 50% likelihood to develop the same. That cannot be prevented; however, changes can be made which can delay the onset and reduce the severity of symptoms of PKD, most notably high blood pressure and kidney failure which may require lifelong dialysis.

Symptoms and complications: The most common symptoms include high blood pressure, kidney pain (behind the back above the buttocks), infections of the kidneys or the bladder, bloody urine, kidney failure, headache, bloated abdomen due to the fluid-filled cysts, frequent urination, and kidney stones. There could be impact on pregnancy plans, with high blood pressure complicating the pregnancy. This needs extra care in management and is not life-threatening in most cases.

Prevention: The kidneys take the brunt of all the toxins that a body is subjected to. It is therefore, very important to reduce the exposure of body, especially kidneys to toxins. One of the best ways to keep the kidneys in good health is to control blood pressure. Some of the ways to do this include:

    Following a low-sodium diet with a good amount of hydration
    Reduce fat in the diet as much as possible
    Include a lot of berries, broccoli and apples
    Be diligent in taking your blood pressure medications as directed
    Ensure that your weight is within the prescribed limits for you
    Quit smoking and drinking
    At least 30 minutes of moderate physical activity should be included in your daily regimen

Read up on symptoms of PKD and keep an eye on them. If you are having a bloated feeling or pain in the kidneys or blood in the urine, consult a doctor. If you are planning on having a baby, genetic counseling may be useful to see if there is a risk of passing on the genes to the baby. Keep a positive outlook and have a frank discussion with family and friends on your overall condition. So, as much as PKD is a hereditary disease, there are ways to manage it and improve the quality of life.

Is Polycystic Kidney Disease Preventable?

Hunner's ulcers, simply put are painful ulcers in your urinary bladder. These ulcers are inextricably linked to another disorder called the painful bladder syndrome or intestinal cystitis. They occur in 10 to 15 percent of people with interstitia cystitis. These, in fact, are red patches or lesions on the bladder wall which can stiffen tissue and cause reduced bladder capacity. Hunner s ulcers bleed, ooze pus and can be of different sizes. The ulcers in the bladder can be extremely painful and uncomfortable.

These are called Hunner s ulcers because they were first described by Dr. Guy LeRoy Hunner, a Johns Hopkins gynecologist, in 1915. Since Hunner s ulcers are seen only in people with intestinal cystitis, it s important to know more about this painful life-altering bladder disorder before we can even understand how to deal with them.

Interstitial cystitis (IC)
IC is also called painful bladder syndrome. Another important thing to know about IC is that it strikes more women than men. IC is a chronic disorder and there s no cure for it. It causes recurring bouts of pain and pressure in the urinary bladder and the pelvic area. This is often accompanied by an urgent and frequent need to urinate. Sufferers may have to rush to the  loo  as much as 40, 50, or 60 times a day.

Diagnosis
Hunner's ulcers can only be accurately diagnosed by doing a cytoscopy which involves inserting a fibre-optic tube through the urethra to look at the bladder wall closely. During this procedure, a tissue sample from the bladder wall is usually also taken to rule out bladder cancer. Cytoscopy is usually done with hydrodistention under local anesthesia. This involves filling the bladder with a liquid for stretching it to provide a closer view of the bladder wall. Usually, a urologist performs this surgery along with a gynaecologist. IC and also Hunner s ulcers are both a diagnosis of exclusion. This means that they re diagnosed only after a number of other conditions have been ruled out.

Hence, the urologist will first take your thorough medical history, followed by a physical exam and a pelvic exam for women patients and perform tests for ruling out infection, and other disorders like bladder stones and cancer, kidney disease, multiple sclerosis, endometriosis, sexually transmitted diseases amongst others. Only after these tests are inconclusive or uncertain and if there is blood in urine, will the urologist go for cystoscopy.

Treatment
There's no cure for IC, but Hunner s ulcers can be cured by burning them off the bladder wall. Called fulguration, the process uses electricity or laser to burn the ulcers on the bladder wall. Resection is also used in which skin from around the Hunner s ulcer is cut for removing both the ulcer and the inflamed tissue around it. The problem is that ulcers may recur in the same location.
So, managing IC becomes critical. Your doctor can try to treat the patient with one treatment or with a combination of treatment depending on the condition of the patient.

Pain medicines are the first line of treatment to manage Hunner s ulcers and IC both, and many patients do go in for this. Patients also find relief by modifying their diet to remove foods and drinks like caffeinated beverages- tea, coffee, colas etc. Sodas, artificial sugars and fruit juices, especially Cranberry juice can trigger intense pain and discomfort, so these are usually contraindicated. Another important aspect is patient education about normal bladder function and tips on self-care and behavioural modifications like stress control to manage Hunner s ulcers.

Hunner's Ulcer In Urinary Bladder - How They Can Be Treated?

Urinary incontinence or the involuntary urination is a common and distressing problem, which may have a large impact on quality of life. The most common types of urinary incontinence in women are stress urinary incontinence and urge urinary incontinence. Women with both problems have mixed urinary incontinence. Stress urinary incontinence is caused by loss of support of the urethra which is usually a consequence of damage to pelvic support structures as a result of childbirth. It is characterized by leaking of small amounts of urine with activities which increase abdominal pressure such as coughing, sneezing and lifting. 

Additionally, frequent exercise in high-impact activities can cause athletic incontinence to develop. Urge urinary incontinence is caused by uninhibited contractions of the detrusor muscle. It is characterized by leaking of large amounts of urine in association with insufficient warning to get to the bathroom in time.

How to diagnose urinary incontinence?

Stress test: The patient relaxes, then coughs vigorously as the doctor watches for loss of urine.
Urinalysis: Urine is tested for evidence of infection, urinary stones, or other contributing causes.
Blood tests: Blood is taken, sent to a laboratory, and examined for substances related to causes of incontinence.
Ultrasound: Sound waves are used to visualize the kidneys, ureters, bladder, and urethra.
Cystoscopy: A thin tube with a tiny camera is inserted in the urethra and used to see the inside of the urethra and bladder.
Urodynamic: Various techniques measure pressure in the bladder and the flow of urine.
Ayurvedic Management of Urinary Incontinence: 
Ayurveda is a very effective natural treatment for Involuntary Urination. Medicines help to treat the root cause of disease. Ayurveda remedies are known to be perfectly safe and have been tried by thousands of patients all over the world bedwetting are perfectly safe. These natural remedies do not have any side effects at all

Urinary Incontinence and How It Can Be Treated with Natural Remedies?

The ideal diet after a kidney transplant

A kidney transplant is a surgical procedure where your kidneys are cleansed and rebuild using the kidneys of a deceased person, in order to flush out the excessive waste fluids from the kidneys. It is of paramount importance and your dietary patterns and lifestyle should be altered after you go through a kidney transplant. Your dietician will help you out by preparing your diet chart to clearly list out the foods that you should consume and those which you should avoid after the surgery. The diet chart that would be prepared for you would be highly subjective and it would totally depend  on your lifestyle, medical history, family health records, genetically transmitted conditions and such others. Apart from improving the condition of your kidney and assisting your transplant, the diet chart will also help you to lose weight, boost your metabolism and enhance your immune system. Some of the most common recommendations that your dietician may give you are as follows:

-Eating at least 5 full servings of fresh fruits and vegetables each day as both are an important part of a healthy diet for a person who has just undergone a kidney transplant. The vegetables should mostly be eaten after cooking/boiling as per the suggestions of your dietician.
-Having enough of fiber rich foods in your daily diet is essential as it speeds up the process of digestion and prevents constipation by promoting frequent and easy bowel movements.
-If you are a non-vegetarian, then you should be going for lean meat alternatives which are low on fat and high on nutritional value. -Examples of such meat are fishes and poultry. Additionally, you should also avoid all kinds of red meat as it is high on fat.
-Consume low-fat milk and dairy products as they help to prevent the fat accumulation inside the body and also maintain an acceptable level of calcium and phosphorus inside your body.
-Maintain a low level of iodized salt in your meals, as it helps to keep your blood pressure under control.
Over the counter health supplements like vitamins and proteins can also be taken, if recommended by your dietician.

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The Ideal Diet after a Kidney Transplant

The presence of blood in urine is known as Haematuria. It is categorized under 2 types:

    Macroscopic haematuria, which means the patient has seen blood.
    Microscopic dipstick haematuria, which means blood is identified by urine microscopy or by dipstick testing either in association with other urological symptoms (symptomatic microscopic haematuria) or during a routine medical examination. It has been variably defined as 3 or more , 5 or more or 10 or more Red Blood Cells (RBCs) per high - power field.

Urological and other Causes of Hematuria

    Cancer: Bladder, Kidney and Prostate Cancer
    Stones: Kidney, Ureteric
    Bladder Infections: Bacterial tuberculosis, infective urethritis Inflammation
    Interstitial Cystitis Trauma : Kidney, bladder, urethra, pelvic fracture causing urethral rupture
    Renal cystic disease: (e.g. medullary sponge kidney)
    Other urological causes: Benign prostatic hyperplasia, vascular malformations
    Other medical causes of haematuria: anticoagulation therapy (e.g. asprin, anti platelet therapy) Nephrological Causes: more likely in children and young adults, proteinuria; red blood cell casts.
    Urological investigations: Urine culture, urine cytology, cystoscopy, renal ultrasonography and intravenous Urography and CT Urography.

Management of haematuria depends on the cause as determined by the urologist.

Causes and Treatment for Hematuria

Second hand smoke may cause bladder cancer. True or false? Take this quiz to know more. 

People with the highest bladder cancer risk are those who?
  Smoke heavily
  Started smoking at a young age
  Have smoked for a long time
  All of the above - Right
Smoking cigarettes enhance the chances of an onset of the bladder cancer. As per studies over one-third of all bladder cancer cases have a link with smoking. Smokers are at increasing risk of getting bladder cancer, which may be up to 4 times that of someone who has never smoked. People who smoke may reduce their risk of getting cancer by passing urine more often. However, there is not enough evidence to support that this is true for everyone. The more you stay away from cigarettes, the better it is.

Which type of chemicals present in cigarette smoke may cause of bladder cancer?
  Formaldehyde
  Carcinogenic chemicals - Right
  Hydrogen cyanide
  All of the above
Cigarette smoke contains carcinogenic chemicals which are harmful to our body and known to cause cancer. When tobacco smoke is inhaled, these cancer-causing chemicals are absorbed into the blood stream. When the blood passes through your kidneys, these chemicals may often get deposited in the urine. As the urine waits in the bladder to be expelled, these harmful chemicals damage the cells lining the bladder, increasing your risk of bladder cancer. Experts believe that healthy eating habits may help in preventing bladder cancer.

Second hand smoke may cause bladder cancer.
  True - Right
  False
The health risks brought on by cigarette smoking are not restricted to smokers. Exposure to secondhand smoke or environmental tobacco smoke significantly increases the risk of cancer in nonsmokers, as well as also a few respiratory ailments in kids. Secondhand smoke is a combination of the smoke that is discharged from the end of a burning cigarette and the smoke emitted from the lungs of smokers. You may use medical masks when going outside, to protect yourself from second-hand smoke.

Aryl-amines present in tobacco decreases the risk of bladder cancer.
  True
  False - Right
As per medical research arylamines such as benzidine, 2-naphthylamine, and 4-aminobiphenyl which are present in tobacco smoke are associated with increasing the chances of getting bladder cancer. Aryl-amines use both an early and a late-stage activity, compatible with a two-mutation theory of bladder carcinogenesis. You may consult your doctor to educate yourself about these harmful effects.

Quitting smoking is a critical step in preventing bladder cancer.
  True - Right
  False
Quitting smoking has major and immediate health benefits for men and women of all ages. Quitting smoking not only decreases the risk of bladder cancer but also reduce the risk of getting a heart attack or chronic lung disease. As per research people who quit before reaching the age 50 reduce their chance of dying by half for the next fifteen years compared with those who continue to smoke. Smoking low-yield cigarettes, as compared to cigarettes with higher tar and nicotine, provides no clear benefit to health. The earlier a person quits, the greater the health benefit.


Bladder Cancer - How Smoking Can Cause It?

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