Sulfasalazine is highly effective in the treatment of ulcerative colitis. The drug acts as a salicylate, thus it reduces inflammation. You doctor may prescribe this medicine for the treatment of other medical conditions as per his discretion.
Take the drug along with some water, after food. Make sure that your increase your fluid intake when seeking treatment with Sulfasalazine. Doses should be taken within 8 hours and should not be missed.
Dizziness as well as drowsiness may occur in patient taking Sulfasalazine. Thus, it is advised that driving and unsafe activities should be avoided. Also avoid consuming alcohol as it can make you dizzy. The drug will also make your skin more sensitive to light, thus protect your skin when you go out in the sun. It can also cause discoloration of the urine.
Some medical problems may hinder the effectiveness of the drug, thus inform you medical practitioner if you have asthma, kidney problems, blood problems, thyroid problems and any allergies.
Also give him a list of all the medicines that you are taking presently. Make sure to include prescription drugs as well as over the counter medicines that you take.
Information given here is based on the salt and content of the medicine. Effect and uses of medicine may vary from person to person. It is advicable to consult a Gastroenterologist before using this medicine.
Spondyloarthritis (also known as spondyloarthropathy) is the term which describes the connective tissue diseases. It is the group of inflammatory diseases, including arthritis of the peripheral joints and spine (sacroiliitis or spondylitis); including the area where ligaments and tendons attach to bones (enthesitis or enthesopathy). These diseases cause pain or stiffness in the leg or arm joints, spine, ligaments and tendons become inflamed. Skin rashes, eye, and intestinal problems may also be able to occur.￼
There are five types of spondyloarthritis
Ankylosing spondylitis or bechterew disease: it is the type of arthritis that affects the spine. Symptoms include pain and stiffness in the lower back and in the neck. Spine bones fuse together and it will become rigid spine and it leads to stoope over posture.
￼Psoriatic arthritis: psoriatic arthritis is the form of arthritis that affects the people who have psoriasis. Most people diagnosed with psoriasis and later diagnosed with psoriatic arthritis. It may affect any part of the body such as fingertips and spine. The main symptoms are joint pain, stiffness, and swelling.
Reactive arthritis: it occurs due to the infection by certain bacteria. Often the bacteria’s from genitals (chlamydia trachomatis) or bowel (campylobacter, salmonella, shigella, and yersinia). It usually targets your knees and joints of ankles or feet.
Undifferentiated arthritis: undifferentiated inflammatory arthritis does not conform to any of the recognized inflammatory arthritis types. It may include monoarthritis of a single joint; oligoarthritis, which is usually when four or fewer joints are involved; or polyarthritis, which usually involves many small joints.
Risk factors may be higher due to following reasons:
Symptoms and complications of spondyloarthritis
The first and major symptoms of all types of spondyloarthritis are severe low back pain, swelling of arms, stiffness, and fatigue. The different types of spondyloarthritis can be manifested by the following signs and symptoms.
Diagnosis and testing
First a doctor may ask for patient’s medical history, physical exam and may suspects for symptoms of spondyloarthritis. To confirm doctor may perform the following diagnosis and tests.
Treatment of spondyloarthritis.
Prevention and control measures
There is no cure for arthritis but there are a number of treatments that may help relieve the pain and disability it can cause.
As couples prepare for pregnancy, it is easy to focus only on the woman's health. However, there are several habits men need to be forming during these critical months of preparation too. Issues of fertility do not rest solely on the female.
'agents that may cause birth defects do not reach the developing fetus through the father as they do from the pregnant mother,' but we do know that male exposure to certain substances can lead to some preliminary problems with fertility and also slightly elevate the risk of certain birth defects.
Male infertility alone accounts for approximately 1/3 of all infertility cases. Should fertility issues arise, you should plan ahead to be in the best physical condition to conceive.
Clean out the medicine cabinet
Eliminate as many medications from your routine as possible. Talk with your physician about your prescription medications. You may need to discontinue use or try something new.
The following medications have been known to impact male fertility:
Take a good look at your work environment
Your work environment may be a contributing factor to your fertility. Ongoing exposure to certain agents such as pesticides, chemical fertilizers, lead, nickel, mercury, chromium, ethylene glycol ethers, petrochemicals, benzene, perchloroethylene, and radiation can lower sperm quality, quantity and possibly lead to infertility or miscarriage.
Adding more vitamin e may also help the process along. There are male fertility supplements available containing vitamins, minerals and other ingredients designed to help improve overall reproductive health.
Also, keep in mind getting plenty of rest is good for everything that ails you, even low sperm count and sperm quality.
Avoid alcohol and other substances
Eliminate alcohol, tobacco, marijuana and any illicit drugs. Too much alcohol may reduce zinc levels, and drugs decrease sperm quality. There is some research that may link smoking and certain rare heart defects, but further studies must be done to make an accurate conclusion. Marijuana has been proven to affect sperm quality and sperm count, but there is no evidence that shows that marijuana causes birth defects.
Keep your testicles cool
Heat from hot tubs, saunas, long showers (more than 30 minutes), heating pads, electric blankets, and tight clothing like briefs and spandex could cause your testicles to become too hot, which decreases sperm quantity.
Stay away from cycling
Cycling can cause a lot of friction and jostling, which increases the temperature of your testicles. The rise in temperature and possibility of injury may cause a low sperm count.
1. What is infertility?
Infertility is a term that is used to describe the inability of an individual to successfully contribute to the process of conception. In females, it refers to their lack of ability to conceive post having regular, unprotected intercourse. In some cases, it also refers to their inability to carry a pregnancy to its full term. A normal fertility helps conception in the first 12 months of trying for almost 86% of couples, with around 7-8% couples conceiving in their second year, depending on their age. Hence, many practitioners also treat an inability to conceive within the first 12 months as infertility.
2. Is infertility a global problem?
Sub-fertility as well as infertility are a global public health issue affecting approx. 8-12% couples, worldwide. It is prevalent in both males and females. While over 10% of women world-wide, who have been in stable relationships for over 5 years yet been unsuccessful in conceiving, have been estimated to be inflicted with this problem; the count is much smaller in the case of men, primarily because of non-acknowledgement, even though it contributes to almost 50% of reported cases.
3. Do infertility problems occur only among women?
No, infertility problems are as common in men as they are in women. Almost 50% of cases of infertility are attributable to male infertility related issues. However, due to the social structure prevalent, most of such male infertility related issues go unacknowledged.
4. What could be the probable symptoms that suggest a possibility of infertility related problems?
Though the process of conception and the possibility of infertility related problems could be time-driven factors, some symptoms could indicate a bent towards infertility and could be medically examined and addressed in time to curb the problem at the very onset. Some of these indications include:
Indications in Females:
Infertility symptoms in females can be related to either one of multiple of these problems:
• Changes in menstrual cycle: Irregular or infrequent periods mean that the number of days between two cycles varies each month. This is a common indication of infertility as it reflects that the ovulation cycle is not stable, i.e. the body is not producing ovules (egg) regularly or at times not at all.
• Abnormalities in periods: Sudden changes in the bleeding pattern – heavier periods, no period or cramping and pelvic pain associated with periods – could also be indicative of an underlying fertility related problem.
• Hormonal Disturbances: Sudden changes in skin like more than usual acne, changes in sexual drive, unexplained and sudden growth of facial hair, excessive weight gain/loss, etc.
• Other Symptoms: Other symptoms such as pain during sex, milky-white discharge from breast/nipples (unrelated to lactation) can also be indicative of infertility and one should seek medical advice at the earliest.
• Age-related: As one advances in age, the egg count decreases rapidly along with a related deterioration in the egg quality. Hence, if a woman is in her early 30s and is failing to conceive, it could be related to a fertility problem.
Indications in Males:
Infertility symptoms in men can be quite elusive as they are very closely related to the cause of infertility. These often go unnoticed until the point that the couple start trying for a baby. Some of these are:
• Sudden changes in sexual drive.
• Pain, inflammation or lump in the testicles or if the testicles are small and firm.
• Problems related to ejaculation and erection
• Sudden, unexplained changes in hair growth patterns.
• Known semen abnormalities
5. Who are at risk of infertility problems?
Age is one of the most crucial risk involved in fertility related matters. For couples who start trying for a baby later in age, the chances of infertility increases manifolds. Couples where either partner is in their mid-30s or into 40s are at higher risk of infertility problems. While a man’s overall lifestyle, health and other factors can affect his chances of contributing to a successful conception, in a woman age and chronic health conditions play a major role.
6. What increases infertility risk in men?
While health and lifestyle are the most important factors that contribute to their fertility levels, including their sperm quality and count, there are many other factors that affect fertility and push towards higher infertility risk among men. Some of these include:
• Alcohol and tobacco consumption
• Excessive physical exercise, especially excessive cycling
• Weight related issues
• Exposure to toxins at workplace or as part of a medical treatment like chemotherapy/radiation
• Surgical procedures like vasectomy or its reversal
• Family history of infertility or fertility related disorders or other genetic medical conditions like cystic fibrosis
• Medical history of sexually transmitted infections (STIs)
• Certain chronic problems like high blood pressure, diabetes, renal or hormonal problems
The major causes of these abnormalities and a consequent infertility in men are:
1. Ejaculation Disorders
2. Frequent use of saunas, hot baths etc. that lead to overheating of testicles.
3. Testicular infections
4. Testosterone deficiency
5. Deformed or undescended testicles that usually happens as a birth defect or abnormal fetal development.
6. Genetic disorders like Klinefelter's syndrome that lead to abnormally developed testicles.
7. Very frequent intake of medications like Sulfasalazine, Anabolic steroids (frequently taken by athletes), etc. or exposure to chemotherapy/radiation.
8. Conditions like hypospadias (a condition where the urethral opening is not at the tip of the penis but at its underside) or cystic fibrosis.
10. What are common causes infertility in women?
There are a number of conditions that lead to fertility among women, such as:
1. Ovarian Disorders: The most commonly reported reason for infertility among women is a disorder in the ovulation process.
Ovulation involves the production and release of egg. This cycle happens on a monthly basis. However, certain situations lead to a malfunctioned ovulation. These causes include:
i. Polycystic ovary syndrome (PCOS) which lead to mal function of ovaries
ii. Very high prolactin levels in non-lactating females
iii. Damaged or abnormal eggs – Poor egg quality is common in older women
iv. Thyroid disorders
v. Medical conditions like cancer, diabetes, AIDS, etc.
vi. Premature (before the age of 40) ovarian failure
2. Uterine Disorders: Once fertilized, the egg travels from the ovary to the uterus and it is important that the uterus be healthy to receive and nurture the fertilized egg. However, at times, disorders of the uterus lead to infertility problems in women. Uterine disorders can be attributed to one or more of these reasons:
i. Pelvic or cervical surgery that may cause scarring or damage of the uterus or fallopian tubes or at times shortening of the cervix which serves as the mouth of the uterus.
ii. Endometriosis – a condition where the cells that line the uterus start growing outside the uterus.
iii. Sterilization treatments like tying of tubes, etc.
iv. Uterine fibroids or endometrial polyps
Rheumatoid arthritis is a chronic inflammatory arthritis with a prevalence of 0.5-1% in India. It is characterized by joint pain and swelling associated with morning stiffness lasting for more than 30 minutes. It generally has a slow onset - over weeks to months, though the onset can be acute also. Most common joints involved are small joints of hands and feet. Larger joints like knee and shoulder can also be involved. The incidence of RA increases with age. It is twice more common in females than in males. Early treatment is necessary to bring down the inflammation, avoid joint deformities and prevent other complications (lung, heart, vasculitis).
Predisposition to RA is multifactorial. It has a genetic component (family history of RA increases the risk). Environmental factors like smoking also play a role.
Initial symptoms start with fatigue, malaise, generalised bodyaches, low-grade fever. The onset is generally slow and eventually patient develops joint pain and swelling. Though the joint involvement is symmetrical in most cases, asymmetric onset is common (involving joints predominantly on one side).
Diagnosis is made by a physician after detailed history, clinical examination and supportive lab tests. Rheumatoid factor and anti-CCP antibody are positive in 75-80% patients with RA. They have raised inflammatory markers (ESR, CRP) during active inflammation.
RA treatment options are wide and quite effective. It starts with patient education regarding nature of the disease and the risk of complications. The need of early aggressive therapy should be emphasized. The patient should put in efforts for physiotherapy which play a very important role in muscle strength and joint mobility. Pharmacotherapy options are wide and include disease-modifying antirheumatic drugs (DMARDS). These can be conventional DMARDS like methotrexate (usually the first line drug), sulfasalazine, hydroxychloroquine, leflunomide. Failure to adequately respond to these drugs should lead your Rheumatologist to consider Biologic DMARDS (TNF antagonists, Rituximab, Abatacept, Tocilizumab). Your Rheumatologist is the best person to guide you about dose, indications, monitoring and side effects of the drugs used in RA. Treatment duration depends on patient's response but is generally long (5-10 years or lifelong).
COMPLICATIONS BEYOND JOINTS:
RA patients can have rheumatoid nodules in skin, lungs, heart and other sites. These patients are at risk of accelerated bone loss, so calcium and vitamin D intake should be optimized. Eye complications include dryness, redness (scleritis and episcleritis) and certain eye threatening complications. Lung involvement can be seen in various forms (fluid in lungs, nodules, interstitial lung disease).
These patients are at high risk of atherosclerosis (heart and blood vessel disease). They also have a tendency to have frequent infections.
NEED OF THE HOUR:
All patients with joint pains should be seen early by Rheumatologist for diagnosis and treatment. With so many treatment options, no patient should suffer from joint deformities and other complications associated with long standing, untreated RA. LEAD A HEALTHY LIFE! If you wish to discuss about any specific problem, you can consult a rheumatologist.