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On 6 Dec I had viral fever for that I took medicine and got recovered by 9 Dec. But till now I am feeling very weakness. Always feeling sleepy and having lower leg pain while walking. Please help me on this.
Gluten is a common thing found in many foods and some people are allergic to this food. When the immune system of the body overreacts to the gluten in food items, it leads to a condition called Celiac disease. Most often, the immune system overreacts to foods like wheat and barley. This can affect the ability of the small intestine to absorb vitamins and minerals and lead to various health complications. While the symptoms are obvious in most cases, it can also be hidden in some people. There is no treatment available for this condition and staying away from gluten food forever is the most suitable remedy.
Types of Celiac Disease
- Classic Celiac Disease: The most common symptoms of this condition are diarrhoea, lack of absorption, steatorrhea, bloating of the abdominal area and loss of weight. It generally affects adults and even children can also get affected in some cases. In children, the bones tend to get weaker and they do not have much energy due to this reason. Also, the appetite will get affected leading to weight loss.
- Atypical Celiac Disease: In this condition, people do not experience the regular symptoms and they usually experience mild discomfort with digestion and lack of energy. This is due to iron deficiency and also leads to a chronic fatigue condition. Some people also experience tingling of the feet and hands or numbness in the region. In severe cases, it can also lead to infertility and depression.
- Asymptomatic Celiac Disease: This is also called silent celiac disease as there are no regular symptoms of the disease. On the other hand, they experience other issues like joint pain and loss of bone density. In some cases, there can be excess fluids in the tissues leading to Edema.
Symptoms of Celiac Disease
The symptoms vary slightly for children and adult patients.
General symptoms for children
- Diarrhoea: If you notice this condition frequently, it is time to approach your doctor as it can be the clear symptom of celiac disease. It happens due to the lack of digestion ability in the body.
- Constipation: While some children tend to develop diarrhoea, some others have constipation problems due to the same condition. The food does not get processed properly in the intestine and it leads to constipation in the long run.
- Bloating of the stomach region: This is a common condition and many children have such symptoms. They tend to get full even after eating a small meal and this reduces the food intake by a huge margin in some cases. All these conditions can later lead to weight loss.
- Loss of weight: This is a clear sign of Celiac disease and you should immediately approach your doctor. After careful examination, they will determine the cause and provide proper suggestions to handle the situation. When children are suffering from this condition, the body does not digest food properly and it reduces the intake of food due to bloating of the stomach. In the long run, this leads to weight loss and general anaemia.
General symptoms for adults
- Pain in the abdominal region: This is usually the result of gas formation in the body and bloating of the stomach. It can cause a lot of pain regularly and you should never neglect this symptom.
- Anaemia: When you are suffering from Celiac disease, the ability of the body to absorb minerals and vitamins reduces drastically and this leads to general anaemia. The blood cells will not be able to carry enough oxygen due to lack of iron. The blood flow to the vital organs gets reduced leading to restlessness and general weakness.
- Rashes: This symptom is usually a result of general weakness and having celiac disease adds to this problem.
- Migraine: When the blood is not able to carry enough oxygen to the brain, it leads to migraine and you should take iron supplements to counter the situation.
- Mouth Ulcers and heartburn: Many people face such problems due to the lack of essential vitamins and minerals in the body. The small intestine loses its ability to completely absorb nutrients and this leads to such problems.
- Loss of weight: As the stomach gets bloated even after eating small quantities of food due to the formation of gas in the body, it gives a fuller feeling and people generally tend to eat less in this situation. Along with that, the lack of nutrients can lead to weight loss for many people.
Causes of Celiac Disease
- The exact cause for Celiac Disease is not known and it is usually due to a combination of different factors.
- When you eat gluten foods, your body does not take it easily and it tends to react by giving some symptoms.
- Even general infections of the gastrointestinal tract can lead to this condition.
- Due to the overreaction of the body to gluten, the small intestine gets damaged and loses its ability to absorb minerals and vitamins from the food. The villi in the small intestine usually get affected after eating gluten food and this weakens the small intestine.
- You will be surprised to know that Celiac disease is very common and it affects about 1 person in every hundred in most western countries.
- It is more common among people suffering from type 1 diabetes and who have autoimmune thyroid disease.
Diagnosis of Celiac Disease
- Begin with a gluten diet for detection: Many people have a general understanding about the Celiac disease and generally stay away from gluten foods to avoid such problems. If you are on a gluten-free diet, you need to get off the routine for some time during the diagnosis phase. Your doctor will introduce slight amounts of gluten to your diet to monitor the reaction of the body and this will be the first method used by them to test for Celiac disease. However, this should be clearly avoided during pregnancy as it can lead to other complications.
- Blood Test: the most common method used is the Serology test that detects the antibodies in the blood. When there is a drastic increase in the level, it indicates some adverse reaction to gluten food.
- HLA Genetic Test: This is usually done after the blood test and it tests for human leukocyte antigens in the body.
- Endoscopy: Finally, few people may be advised to undergo endoscopy to determine the overall condition of the intestine. The biopsy is conducted carefully to assess the villi damage and this determines the stage of the disease.
Prevention of Celiac Disease
Unfortunately, there is no way in which you can prevent this disease. However, when you have this disease, you can take care of and prevent the symptoms by indulging in a gluten-free diet. It is a good idea to eat more fruits and vegetables along with seafood and meat. It is also important to note that Rice is gluten-free and you can freely include it in your everyday diet.
Treatment for Celiac Disease
- Eating a gluten-free diet: This is probably the only thing you can do when it comes to treating Celiac disease. Remember that there is no foolproof treatment available for this condition and you should take care of your eating habits throughout your life. This needs lifelong care about your diet and always make sure that you read the labels for gluten content. It is very easy to manage a good nutritional gluten-free diet after consulting your doctor. They may even refer you to a dietician and you can follow the guidelines given by them and get some relief for your health problems.
- Nutritional supplements: It is important to get a regular dose of vitamins and minerals so that your body can function to the optimum level. Make sure that you include calcium and iron supplements along with Vitamins K, D and B12 as they enhance the overall functioning of your body and you can cope up with the symptoms in a better way. Your doctor will be the best person to prescribe the suitable vitamin supplement needed for your body after careful examination.
- The decrease in bone density: This happens due to lack of calcium in the body. With celiac disease limiting the efficiency of the intestine, it will not be able to absorb enough calcium through food source and the bones become weaker in the long run. This leads to osteoporosis in some cases due to a decrease in bone density.
- Lactose intolerance: In normal condition, the lactose is digested by the small intestine. When you are suffering from Celiac Disease, the intestine will not be able to digest the lactose and you become intolerant to lactose. This means that drinking milk and other substances containing lactose can affect your health condition.
- Malnutrition: As the ability of the small intestine to absorb vitamins and minerals from the food decreases, people tend to become nutrient deficient and this leads to malnutrition. In general, you will notice lack of calcium, iron, zinc and other essential vitamins in people suffering from this condition. This condition affects both children as well as adults.
- Infertility: This condition affects women more than men and they find it difficult to get pregnant. Even when they manage to get pregnant, the chances of miscarriage increases a lot with such condition. Not having enough nutrition can also increase the chances of getting a miscarriage when you are suffering from celiac disease.
- Cancer: In some cases, having celiac disease can lead to Lymphoma where the immunity is damaged very badly and cancer cells begin to thrive in the body. However, not every person suffering from Celiac disease will develop cancer and it happens only in a few cases.
Myths about Celiac Disease
Myth #1: Rice contains gluten:
This is completely false and you can include rice in your regular diet. This is a good alternative to other foods like wheat and barley and it is very safe for people suffering from Celiac Disease. Always read the food labels to know if it contains any gluten and you can easily avoid such foods in this manner.
Myth #2: Low amounts of gluten are alright:
If you are suffering from Celiac Disease, you should be very strict with your food habits and always avoid gluten at any cost. Remember that even low amounts of gluten in the food can affect your health. In some cases, even when you eat food that is contaminated with other gluten foods, the symptoms can trigger immediately and spoil your health.
Myth #3: Celiac problem is generic food allergy:
This is not a food allergy and it is an autoimmune disease. If proper care is not taken about this condition, it can severely affect the health condition in the long run. Medical examination and guidance are necessary to handle the problem. The working of the small intestine can get affected due to this condition and this leads to malnutrition and overall weakness in the long run.
Myth #4: Celiac disease is a genetic problem:
This is not true and people with a family history of celiac disease need not always get this autoimmune disease. However, the chances of getting this disease increases when it is combined with other factors.
When you are diagnosed with Celiac disease, there is no need to panic as it can be managed effectively when you have a strict gluten-free diet. Always take the help of your dietician to manage your everyday diet and this will help you to avoid gluten foods. When you stay away from gluten foods for a few months, you can notice a significant improvement in the overall health condition. In some cases, when the damage to the intestine is too much, doctors can even suggest some medications to control the damage. With proper care, it becomes easy to manage the condition. However, you must remember that the fight must continue for the rest of your life and you should get adjusted to a gluten-free diet so that your immune system does not get agitated in any manner in future.
Bell’s Palsy is a disease, which causes a sudden, temporary weakness in the facial muscles. It is facial paralysis that makes patients unable to control his facial muscles on either side of his face. This disease can occur at any age.
There is no known reason for its cause. However, the disease is believed to be caused because of swelling and inflammation of the nerve that controls the muscles on the affected side. The risk factors include diabetes and upper respiratory tract infection. This is caused due to the malfunction of the cranial nerve.
Bell’s Palsy affects millions of people worldwide. For most of them, the disease is temporary. The symptoms usually start to improve within a few weeks from the first appearance. The complete recovery takes close to six months. There are a few people who continue to have the Bell’s Palsy for their complete life. The disease rarely affects someone twice. People who recurrently face the disease are often found to be a victim of diabetes or viral infections.
People, often, unknowingly interpret the disease as a stroke. It, however, is not a stroke. A stroke affecting the facial muscles would also affect the body muscles and cause weakness in other parts of the body too.
Bell’s Palsy Causes-
The causes that trigger Bell's Palsy in the human body are still unknown. Often researchers associate it with an exposure to a viral infection. The facial nerve passes through a narrow bony area in the skull and when it swells, it pushes against the hard surface of the skull when there is a viral infection. Apart from the facial muscles, the disease also affects tears, saliva, taste and a small bone positioned in the middle of the ear. At other times, researchers also associate it with physical damage to the facial nerve that causes a similar swelling of the face.
Mostly the disease occurs due to viral infections. The infections play an important role in the development of the disease. The viruses that are linked to the development of the disease are:
1. Cold sores and genital herpes, also known as herpes simplex
3. Infectious mononucleosis, which is also known as herpes zoster
4. Cytomegalovirus infections
5. Respiratory illnesses or adenovirus
6. German measles or rubella virus
7. Mumps or the mumps virus
8. Flu or the influenza B virus
9. Hand-foot-and-mouth disease or the coxsackievirus
Some Risk Factors of Bell’s Palsy-
It has often been noticed that Bell ’s palsy follows a pattern when affecting people. These include:
1. The disease often occurs in females who are pregnant and are in the third trimester of the gestation period. It can also affect the mother after the first week of the birth.
2. People having an upper respiratory infection, such as the flu and the cold, are commonly affected.
3. People having diabetes are also frequently affected.
As mentioned before, the disease rarely affects the same person recurrently. If there is a family history of the disease recurring repeatedly, it suggests a genetic trait or predisposition of the disease.
Bell’s Palsy Symptoms-
There are a few symptoms which constantly recur when Bell’s Palsy strikes a person. These symptoms include:
1. Inability to move the eyelid or blinking.
2. The eye on the affected side of the face waters more or less than it occurs usually.
3. Drooling even in a conscious state.
4. A reduced sense of taste in the mouth.
5. Twitching of the facial muscles.
Of all the symptoms drooling and facial weakness, reach their peak in a day or two. These symptoms then begin to reduce, which helps people to recover within a couple of weeks. Complete recovery happens within 3 months. Some of the patients may show neurological symptoms, which are defined as mononeuritis. This is what causes the tingling, headache, memory and balance problems. Other symptoms, which are unexplained by the facial nerve dysfunction, are ipsilateral limb weakness, ipsilateral limb paresthesias, and clumsiness.
Bell’s Palsy Diagnosis-
Bell’s Palsy is a disease which requires the diagnosis of exclusion. As there is no specific test for the disease, the doctor observes the diseased person’s face and asks him to move various parts of his face, including the facial muscles, for instance, closing the eyes, lifting the brow, showing the teeth and various other movements. Observing these parts, the doctor eliminates various other possibilities and tries to determine a reasonable cause for the disease.
As the disease is treated on the basis of exclusion, there is no routine testing or imaging test that can help in the diagnosis process. However, the degree of the nerve damage can be assessed using the House-Brackmann score. There are many studies, which have revealed that 45% of patients are not referred to a specialist. This simply suggests that the disease requires a straightforward diagnosis and is easy to manage.
Differential Diagnosis of Bell’s Palsy-
As there is no particular diagnosis in the treatment of the disease, doctors make use of the differential diagnosis technique in the treatment of Bell’s Palsy. In differential diagnosis, doctors distinguish a particular disease from other diseases that present similar clinical features. The technique finds its usage while diagnosing a particular disease to eliminate imminently life-threatening conditions.
During the differential diagnosis of Bell’s Palsy, there are various diseases which are easily eliminated such as a stroke. However, it is very difficult to eliminate the involvement of the facial nerve with the herpes zoster virus. In order to understand the major difference between the two, one must look for the small blisters on the external ear.
The Lyme’s disease also produces facial palsy, which occurs at the same time as the classic erythema migraine rash. Other times, it occurs at a later stage. In cases where the Lyme disease is common to the Bell’s Palsy disease, it may lead to facial palsy.
Bell’s Palsy Treatment-
As mentioned before, a vast majority of people have shown improvement in health and recovered completely from the disease with and at certain times, without treatment. There is no designated treatment for the disease. Doctors may suggest various medications or physical therapies that help to speed up the recovery of the patient. The medicines may vary from doctor to doctor. However, these medications may differ in accordance with the doctor. Surgery is rarely a solution or option in case of Bell’s Palsy.
Having said that, there are various procedures for the treatment of Bell’s Palsy. They include usage of the following:
5. Alternative Medicinal Therapies
1. Steroids – Various steroids such as corticosteroids, improve recovery of the patient within 6 months. Due to this, early administration of corticosteroids such as prednisone is recommended. The early treatment is necessary as it provides the patient with around 14% higher chances of recovery.
2. Antivirals –Various tests and reviews have shown that antivirals are not as effective in treating the disease as steroids. In fact, they are only beneficial in cases that display some form of mild diseases. There is another review, which stated that antivirals combined with corticosteroids were advantageous for the duration of the treatment. There is a huge amount of speculation when it comes to using antivirals for the treatment. However, antivirals still result in a benefit, which is slightly less than 7%, and therefore this course of treatment is not ruled out.
3. Physiotherapy – Physiotherapy helps in maintaining the tone of the impacted facial muscles and stimulating the facial nerve. Because of this, physiotherapy can be beneficial to some individuals.
4. Surgery – Surgery may help patients recover from facial nerve palsy. There are various techniques that exist to assist with the process of surgery. A form of surgery is a procedure that is beneficial in restoring the smile of patients suffering from facial nerve paralysis. However, this is a surgery that can be as harmful as it is beneficial. There are various side effects associated with the surgical technique. One may experience total hearing disability. In fact, around 3-15% patients experience hearing loss after the surgery.
5. Alternative Medicinal Therapies – Alternative Medicinal Therapies include various techniques such as acupuncture on the affected region. Paralyzed muscles often tend to shrink and shorten causing permanent contractures and pain. Physical therapies can guide the patient to prevent such an incident from occurring.
However, the efficiency of such techniques still remains unknown to the doctors. This is due to the fact that the studies conducted are available in a low quality. Another therapy is the hyperbaric oxygen therapy. However, the evidence available for the therapy is quite tentative.
Myths related to Bell’s Palsy
Bell’s Palsy disease often confuses people leading them to believe various myths. The most prominent myths include:
Myth #1: Bell’s Palsy Causes Permanent Facial Paralysis
Bell’s Palsy is a form of temporary facial paralysis. The facial nerve that is on one side of the face is disrupted. Due to this, the message, which is received from the brain, is interfered. However, in a majority of cases, the disease is temporary. The paralyzed area of the face starts to cure within a few weeks and within three to six months; the paralysis completely disappears on its own. In a few percentages of cases, the nerve function does not return to normal. The nerve function may return but the full function does not return.
Myth #2: There is No Treatment Which Ensures the Treatment of Bell’s Palsy
There are various techniques which are available for the treatment of Bell’s Palsy. As mentioned above, the disease can be defeated using steroids, antivirals, physiotherapy, surgery and alternative medicinal therapies. These are the most effective treatments for the disease. Apart from this, selective neurolysis and botox can be used to treat the disease.
Selective neurolysis involves releasing a platysma muscle downward and reducing the activity. The selective neurolysis is very useful for a patient to regain his ability to smile. The botox treatment is a non-surgical treatment. When injected by a nerve expert, it helps patients to regain some symmetry into their faces and improve their facial appearance.
Myth #3: Prognosis of the Disease is not Very Good
There are many people who are under the impression that prognosis for Bell’s Palsy is not very good and hence they hesitate in using it for the treatment. However, doctors state that prognosis is generally very good for the patients.
After making use of the prognosis method, a person starts to improve on his symptoms within the first two weeks. The duration for complete recovery remains the same, i.e. three to six months.