Heart Disease: Causes of a Heart Attack
In women, the increase continues sharply until age 60 to 65 years. Cherry hemangioma Halo nevus Spider angioma. Please see this interview with Dr. On rare occasions, clots arising from the left atrium or left ventricle may enter the coronary vessels and cause acute obstruction and symptoms of disease. One of the most troubling side effects of statins that has only recently become apparent is their potential to increase the risk of diabetes, especially in women.
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Monounsaturated fats and polyunsaturated fats, such as canola oil and some nuts, contain the beneficial linolenic acid a type of omega-3 fatty acid. Omega-3 fatty acids lower triglycerides, decrease blood clotting, are associated with decreased sudden heart attack, improve the health of your blood vessels, and help moderate blood pressure. Fatty fish — such as mackerel, lake trout, herring, sardines, albacore tuna and salmon — are rich sources of omega-3 fatty acids.
Fish is eaten on a regular basis in the Mediterranean diet. The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking. However, alcohol — in moderation — has been associated with a reduced risk of heart disease in some research studies.
The Mediterranean diet typically includes a moderate amount of wine. This means no more than 5 ounces milliliters of wine daily for women or men over age 65 , and no more than 10 ounces milliliters of wine daily for men under age If you're unable to limit your alcohol intake to the amounts defined above, if you have a personal or family history of alcohol abuse, or if you have heart or liver disease, refrain from drinking wine or any other alcohol.
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A heart-healthy eating plan The heart-healthy Mediterranean diet is a healthy eating plan based on typical foods and recipes of Mediterranean-style cooking. By Mayo Clinic Staff. The Mayo Clinic Diet Book: Mayo Clinic on Digestive Health Book: Mayo Clinic Going Gluten-Free.
See also Mediterranean diet Butter vs. Does diet play a role? Go for the greens Fast-food tip: Have it your way Fast-food tip: Keep it small Fast-food tip: Opt for grilled items Fast-food tip: Skip the fries Fast-food tip: Watch what you drink Fasting diet: Can it improve my heart health?
Gluten sensitivity and psoriasis: Gluten-free diet Glycemic index diet Gout diet: What's allowed, what's not Having fast food? Metronidazole and alcohol together can cause severe nausea, vomiting, cramps, flushing, and headache. Patients taking metronidazole should avoid alcohol. Other side effects of metronidazole include nausea, headaches , loss of appetite , a metallic taste , and, rarely, a rash.
Ciprofloxacin Cipro is another antibiotic used in the treatment of Crohn's disease. It can be used in combination with metronidazole. Decreasing the activity of the immune system with immuno-modulators increases the risk of infections; however, the benefits of controlling moderate to severe Crohn's disease usually outweigh the risks of infection due to weakened immunity.
Examples of immuno-modulators are:. Azathioprine Imuran, Azasan and 6-mercaptopurine 6-MP, Purinethol are medications that weaken the body's immune system by reducing the population of a class of immune cells called lymphocytes.
Azathioprine and 6-MP are related chemically. In high doses, these two drugs have been useful in preventing rejection of transplanted organs and in treating leukemia. In low doses, they have been used for many years to treat patients with moderate to severe Crohn's disease and ulcerative colitis.
Azathioprine and 6-MP are increasingly recognized as valuable drugs in treating Crohn's disease and ulcerative colitis. A majority of patients with moderate to severe disease will benefit from these drugs. Azathioprine and 6-MP are used primarily in the following situations:.
Side effects of azathioprine and 6-MP include increased vulnerability to infections, inflammation of the liver hepatitis and the pancreas pancreatitis , and bone marrow toxicity interference with the formation of cells that circulate in the blood. One problem with 6-MP and azathioprine is their slow onset of action. Typically, full benefit of these drugs is not realized for three months or longer.
During this time, corticosteroids frequently have to be maintained at high levels to control inflammation. Studies have shown that giving higher doses of 6-MP early can hasten the benefit of 6-MP without increasing the toxicity in most patients, but some patients do develop severe bone marrow toxicity. Scientists now believe that an individual's vulnerability to 6-MP toxicity is genetically inherited.
Blood tests can be performed to identify those individuals with increased vulnerability to 6-MP toxicity. Blood tests also can be performed to measure the levels of certain by-products of 6-MP. The levels of these by-products in the blood help doctors to more quickly determine whether the dose of 6-MP is right for the patient.
Azathioprine is converted into 6-MP in the body and 6-MP then is partially converted in the body into inactive and non-marrow toxic chemicals by an enzyme called thiopurine methyltransferase TPMT.
These chemicals then are eliminated from the body. Thus, when given normal doses of azathioprine or 6-MP, these patients with reduced or absent TPMT activities can develop seriously low white blood cell counts for prolonged periods of time, exposing them to serious life-threatening infections.
Patients found to have genes associated with reduced or absent TPMT activity are treated with alternative medications or are prescribed substantially lower than normal doses of 6-MP or azathioprine.
Rarely, a patient with normal TPMT genes can develop severe toxicity in the bone marrow and a low white blood cell count even with normal doses of 6-MP or azathioprine.
Also, hepatotoxicity in the presence of normal TPMT levels has been reported. All patients taking 6-MP or azathioprine regardless of TPMT genetics have to be closely monitored by periodic blood counts and liver enzyme tests for as long as the medication is taken.
Allopurinol Zyloprim , used in treating high blood uric acids levels, can induce bone marrow toxicity when used together with azathioprine or 6-MP. Allopurinol Zyloprim used together with azathioprine or 6-MP has similar effect as having reduced TPMT activity, causing increased accumulation of the 6-MP metabolite that is toxic to the bone marrow.
In addition to monitoring blood cell counts and liver tests , doctors also may measure blood levels of the chemicals that are formed from 6-MP 6-MP metabolites , which can be helpful in several situations such as if a patient's disease:.
Patients have been maintained on 6-MP or azathioprine for years without significant long-term side effects.
Patients on long-term azathioprine or 6-MP, however, should be closely monitored by their doctors. There are data suggesting that patients on long-term maintenance fare better than those who stop these medications.
Thus, those who stop azathioprine or 6-MP are more likely to experience recurrence of their disease and are more likely to need corticosteroids or undergo surgery. Infliximab is approved for the short-term treatment of moderate to severe Crohn's disease patients who respond inadequately to corticosteroids, azathioprine, or 6-MP.
Infliximab Remicade is an antibody that attaches to a protein called tumor necrosis factor-alpha TNF-alpha. TNF-alpha is one of the proteins produced by immune cells during activation of the immune system. TNF-alpha, in turn, stimulates other cells of the immune system to produce and release other proteins that promote inflammation.
In Crohn's disease, there is continued production of TNF-alpha as part of the immune activation. Infliximab, by attaching to TNF-alpha, blocks its activity and in so doing decreases the inflammation. Infliximab generally is well-tolerated. There have been rare reports of side effects during infusions, including chest pain , shortness of breath , and nausea. These effects usually resolve spontaneously within minutes if the infusion is stopped.
Other commonly-reported side effects include headache and upper respiratory tract infection. TNF-alpha is an important protein for defending the body against infections. Infliximab, like immunomodulators, increases the risk for infection. One case of salmonella colitis and several cases of pneumonia have been reported with the use of infliximab. There also have been cases of tuberculosis TB reported after the use of infliximab.
More recently, a rare form lymphoma called hepatosplenic T-cell lymphoma has been described associated with azathioprine therapy for Crohn's disease either alone or in combination with infliximab.
Although there is not much known about this disease, it appears to be aggressive and poorly responsive to treatment.
Because infliximab is partly a mouse protein, it may induce an immune reaction when given to humans, especially with repeated infusions. In addition to the side effects that occur while the infusion is being given, patients also may develop a delayed allergic reaction that occurs 7 to 10 days after receiving the infliximab.
This type of reaction may cause flu-like symptoms with fever, joint pain and swelling, and a worsening of Crohn's disease symptoms. It can be serious, and if it occurs, a physician should be contacted.
Paradoxically, those patients who have more frequent infusions of infliximab are less likely to develop this type of delayed reaction compared to those patients who receive infusions separated by long intervals months. Rare cases of nerve inflammation such as optic neuritis inflammation of the nerve of the eye and motor neuropathy also has reported with the use of infliximab.
Infliximab can aggravate and cause the spread of an existing infection. It should not be given to patients with pneumonia , urinary tract infections , or abscess localized collection of pus. It is recommended that patients be tested for TB prior to receiving infliximab. Patients who previously had TB should inform their physician of this before they receive infliximab. Infliximab also can cause the spread of cancer cells and it should not be given to patients with cancer.
Infliximab can promote intestinal scarring part of the process of healing and can worsen strictures narrowed areas of the intestine caused by inflammation and subsequent scaring and lead to intestinal obstruction. It also can cause partial healing partial closure of anal fistulae.
Partial closure of fistulae impedes drainage of fluid through the fistulae, and may result in collections of fluid in which bacteria multiply, which can result in abscesses.
The effects infliximab on the fetus are not known, although the literature suggests this medication is safe for women to continue until week 32 of pregnancy. At that time, the risk of exposure of the fetus to this medication via placental transfer is increased. Infliximab is listed as a pregnancy category B drug by the FDA meaning that animal studies show no increased risk, but there are no human studies. Because infliximab is partly a mouse protein, some patients can develop antibodies against infliximab with repeated infusions.
Such antibodies can decrease the effectiveness of the drug. The chance of developing such antibodies can be decreased by the concomitant use of 6-MP and corticosteroids. There are some reports of worsening heart disease in patients who have received infliximab Remicade. The precise mechanism and role of infliximab in the development of this side effect is unclear.
As a precaution, individuals with heart disease should inform their physician of this condition before receiving infliximab. The long-term safety and effectiveness is not yet known although recent 10 year data from patients who received at least 1 dose of infliximab for CD showed the safety profile similar to what was previously known.
In that data set, the treated patients seemed to have an increased risk of developing infections, infusion reactions, autoimmune reactions, and malignancy.
Vedolijumab Entyvio is a type of monoclonal antibody called an integrin receptor antagonist indicated for adults with moderate to severe ulcerative colitis UC or moderate to severe Crohn's disease CD when certain other UC or CD medicines have not worked well enough or cannot be tolerated. Entyvio may help to reduce some symptoms, achieve remission, and reduce or stop the use of corticosteroids. Entyvio works to block the movement of certain gut directed white blood cells into the gastrointestinal GI tract, which helps control inflammation and may reduce the symptoms of UC and CD.
The most common side effects of Entyvio include common cold symptoms runny or stuffy nose, sinus pain, sneezing , cough , headache, joint pain, nausea, fever, infections of the nose and throat, tiredness , fatigue , upper respiratory tract infection , bronchitis , flu symptoms , back pain , rash, itching , sinus infection , sore throat , and pain in your arms or legs. Serious side effects of Entyvio include infusion reactions, serious allergic reactions, infections, progressive multifocal leukoencephalopathy PML , and liver problems.
Stelara is also used to treat plaque psoriasis and psoriatic arthritis. The most common side effects of Stelara include injection site reactions bruising , itching, pain, redness, swelling, and hardening of the skin , cold symptoms stuffy nose, sneezing, sore throat , headache, tired feeling, diarrhea, or skin rash or itching.
Serious side effects of Stelara include serious allergic reactions including feeling faint; swelling of your face, eyelids, tongue, or throat; chest tightness , or skin rash. Methotrexate has been used for many years in the treatment of severe rheumatoid arthritis and psoriasis. It has been helpful in treating patients with moderate to severe Crohn's disease who are either not responding to azathioprine and 6-MP or are intolerant of them.
Methotrexate also may be effective in patients with moderate to severe ulcerative colitis who are not responding to corticosteroids, azathioprine, or 6-MP. One major complication of methotrexate is the development of liver cirrhosis when the medication is given over a prolonged period of time years. The risk of liver damage is higher in patients who also abuse alcohol or are severely obese.
Other serious side effects of methotrexate include low white blood cell counts and inflammation of the lungs. Methotrexate should not be used in pregnant women because of toxic effects on the fetus. Aspirin is an anti-inflammatory drug that has been used for many years for treating arthritis, bursitis, and tendonitis conditions of tissue inflammation. Aspirin is not effective in treating Crohn's disease and ulcerative colitis and may even worsen the inflammation. Studies suggest that aspirin might actually decrease future risk of developing colorectal cancer in the general population.
Biosimilar medications for Crohn's disease. A biosimilar medication is a drug product that is made to be similar to another already-approved drug. It is tested to be the same as its reference drug in terms of clinical uses, effectiveness, and product safety.
A biosimilar medication must meet specific strict standards to be approved by the FDA. A biosimilar is not a generic form of a drug. A generic drug contains the same compounds as the original drug, while a biosimilar drug is highly similar to the reference drug, but not identical. Examples of biosimilars are Infliximab-abda Renflexis and Infliximab-dyyb Inflectra. Infliximab-abda Renflexis is biosimilar to infliximab Remicade.
Renflexis is a tumor necrosis factor TNF blocker used to reduce: The number of draining enterocutaneous and recto-vaginal fistulas and maintains fistula closure in adult patients with fistulizing disease.
Renfexis is also used to treat ulcerative colitis, rheumatoid arthritis in combination with methotrexate , ankylosing spondylitis , psoriatic arthritis , and plaque psoriasis. The most common side effects of Renflex is include infections upper respiratory infection , sinus infection, throat infection, bronchitis , urinary tract infection , infusion-related reactions, headache, abdominal pain, fever or chills , cardiopulmonary reactions chest pain , high or low blood pressure , shortness of breath , itching, hives, nausea, diarrhea, indigestion , cough , rash, fatigue , yeast infection , and joint pain.
Serious side effects of Renflex is include serious infections, heart failure, liver injury, blood problems, nervous system disorders, allergic reactions, Lupus -like syndrome, and psoriasis. Infliximab-dyyb Inflectra is biosimilar to infliximab Remicade. Infusion reactions can happen up to two hours after an infusion. Symptoms of infusion reactions may include fever, chills, chest pain, low blood pressure hypotension or high blood pressure hypertension , shortness of breath, rash and itching.
Serious side effects of Inflectra include serious infections, heart failure, liver injury, blood problems, nervous system disorders, allergic reactions, Lupus -like syndrome, and psoriasis. Surgery in Crohn's disease. There is no surgical cure for Crohn's disease.
Even when all of the diseased parts of the intestines are removed, inflammation frequently recurs in previously healthy intestines months to years after the surgery. Surgery in Crohn's disease is used primarily for:. Usually, after the diseased portions of the intestines are removed surgically, patients can be free of disease and symptoms for some time, often years.
When successfully performed, can lead to a marked improvement in a patient's quality of life. Crohn's disease eventually returns, affecting previously healthy intestines. The recurrent disease usually is located at or near the site of surgery. In fact, half of patients can expect to have a recurrence of symptoms within four years of surgery. Drugs such as Pentasa or 6-MP have been useful in some patients to reduce the chances of relapse of Crohn's disease after surgery.
There is accumulating evidence in favor of post-operative therapy to delay recurrence in Crohn's disease. There appears to be some benefit of mesalamine in reducing the risk of post-op recurrence for up to 3 years. A study has shown infliximab to be effective in preventing postoperative recurrence after ileocecal resection, though relapse may occur when therapy is stopped.
What are the complications of Crohn's disease? Complications of Crohn's disease may be related or unrelated to the inflammation within the intestine. Massive distention or dilatation of the colon megacolon , and rupture perforation of the intestine are potentially fatal complications. Both generally require surgery, but, fortunately, these two complications are rare.
Recent data suggest that there is an increased risk of cancer of the small intestine and colon in patients with long-standing Crohn's disease. Extra-intestinal complications involve the skin, joints, spine, eyes, liver, and the bile ducts. Skin involvement includes painful red raised spots on the legs erythema nodosum and an ulcerating skin condition generally found around the ankles called pyoderma gangrenosum.
Painful eye conditions uveitis , episcleritis can cause visual difficulties. Inflammation of the low back sacroiliac joint arthritis and of the spine ankylosing spondylitis can cause pain and stiffness of the spine. Inflammation of the liver hepatitis or bile ducts primary sclerosing cholangitis also can occur. Sclerosing cholangitis causes narrowing and obstruction of the bile ducts draining the liver and can lead to yellow skin jaundice , recurrent bacterial infections , and liver cirrhosis with liver failure.
Sclerosing cholangitis with liver failure is one of the reasons for performing liver transplantation. It also is frequently complicated by the development of cancer of the bile ducts. Patients with Crohn's disease might also suffer from an increased tendency to form blood clots hypercoagulability. What is the prognosis and life expectancy for Crohn's disease? Crohn's disease is a chronic inflammatory disease involving predominantly the small intestine and colon.
The symptoms and the activity of the disease can come and go. Even though many effective medications are available to control the activity of the disease, there is as yet no cure for Crohn's disease. Surgery can significantly improve the quality of life in selected individuals, but recurrence of the disease after surgery is common. The disease can have complications, both within and outside of the intestine.
Newer treatments are actively being evaluated. A better understanding of the role of genetics and environmental factors in the cause of Crohn's disease may lead to improved treatments and prevention of the disease. Learn about Crohn's disease symptoms, signs, diet, treatment, symptoms of Crohn's disease in women, Crohn's disease in children, and more. Can Crohn's disease be cured?
The symptoms of Crohn's disease can vary greatly from patient to patient. What were your symptoms at the onset of your disease? What diet changes did you have to make, or continue to make to control the symptoms of your Crohn's disease?
Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain diseases, and infections. Treatment options include medicine including, local anesthetics, for example, lidocaine Xylocaine , pramoxine Fleet Pain-Relief , and benzocaine Lanacane Maximum Strength , vasoconstrictors, for example, phenylephrine 0.
Crohn's Disease - Symptoms Patient Comments: Crohn's Disease - Diet Patient Comments: Crohn's Disease - Treatment Patient Comments: Crohn's Disease - Medications Find a local Gastroenterologist in your town Crohn's disease definition and facts What is Crohn's disease?
Is Crohn's Disease Contagious? Test Your Medical IQ. Inflammatory Bowel Disease Slideshow. Readers Comments 45 Share Your Story. Readers Comments 28 Share Your Story. Readers Comments 7 Share Your Story. Readers Comments 10 Share Your Story. Regueiro, MD, et al. Related Article Crohn's Disease Quiz Learn about Crohn's disease symptoms, signs, diet, treatment, symptoms of Crohn's disease in women, Crohn's disease in children, and more. Post View 45 Comments Crohn's Disease - Diet What diet changes did you have to make, or continue to make to control the symptoms of your Crohn's disease?
Have any of them helped with symptoms? Post View 10 Comments. Learn the difference between a stomachache and more serious causes of abdominal pain. Diagnosis of abdominal pain is based on symptoms and the location of pain, like sharp pain in the lower abdomen.
If anal itching persists, a doctor examination may be needed to identify an underlying cause. C-reactive protein or CRP is a blood test that doctors can use to detect risk of heart disease, heart attack, stroke and peripheral arterial disease. CRP is a highly reactive protein that is found when there is general inflammation within the body. CRP levels seem to be able to predict cardiovascular risk at least, and cholesterol levels.
Canker sores are a common complaint, and are small ulcers on the inside of the mouth. Canker sores aren't contagious as opposed to cold sores , and typically last for days usually healing without scarring. A variety of things cause canker sores, for example, medications aspirin, beta-blockers, NSAIDs, high blood pressure medication, and antibiotics ; injury to the mouth from dental work, braces, or sports accidents; acidic foods; allergies; and diseases or conditions like celiac disease, Crohn's disease, and lupus.
Canker sores can be cure with home remedies, and prescription and OTC topical and oral medication. Colitis refers to inflammation of the inner lining of the colon. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool.
There are several causes of colitis, including infection, ischemia of the colon, inflammatory bowel disease Crohn's disease, ulcerative colitis, infectious colitis like C. Treatment depends on the cause of the colitis.
A colonoscopy is a procedure whereby a docotor inserts a viewing tube colonoscope into the rectum for the purpose of inspecting the colon. Colonoscopy is the best method currently available to diagnose, detect, and treat abnormalities within the colon.
How is Crohn's treated? Take this quiz to get the facts about Crohn's. Get more information on this digestive disorder and how Crohn's can affect your diet. Learn more about tests to diagnose Crohn's disease, as well as treatments for Crohn's. Diarrhea is a change is the frequency and looseness of bowel movements. Symptoms associated with diarrhea are cramping, abdominal pain, and the sensation of rectal urgency. Causes of diarrhea include viral, bacterial, or parasite infection, gastroenteritis, food poisoning, and drugs.
Absorbents and anti-motility medications are used to treat diarrhea. Endoscopy is a broad term used to described examining the inside of the body using an lighted, flexible instrument called an endoscope.
Endoscopy procedure is performed on a patient to examine the esophagus, stomach, and duodenum; and look for causes of symptoms such as: What is inflammatory bowel disease? IBD can include Crohn's disease and ulcerative colitis. Learn more about testing, treatments, and the home care needed to manage inflammatory bowel disease. An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood. Under normal circumstances, these enzymes reside within the cells of the liver.
But when the liver is injured, these enzymes are spilled into the blood stream, and can lead to diseases like fatty liver, type 2 diabetes, obesity, and hepatitis. Several medications also can increase liver enzyme test results. Stool color changes can very from green, red, maroon, yellow, white, or black. Causes of changes of stool color can range from foods a person eats, medication, diseases or conditions, pregnancy, cancer, or tumors.
Stool can also have texture changes such as greasy or floating stools. Stool that has a uncharacteristically foul odor may be caused by infections such as giardiasis or medical conditions. The tuberculosis skin test is based on the fact that infection with M. The standard recommended tuberculin test is administered by injecting 0.
The area of induration palpable, raised, hardened area around the site of injection is the reaction to tuberculin.
Get a better idea of what's causing the nausea, vomiting, bloating, gas, constipation, diarrhea, pain, and other gastrointestinal discomforts and problems. Take the Tummy Troubles Quiz! Ulcerative Colitis is a form of inflammatory bowel disease and is slightly different than Crohn's disease.
Your diet can impact the severity of your symptoms. Learn the causes, symptoms, and treatment options associated with ulcerative colitis. Uveitis pronounced you-vee-EYE-tis involves all inflammatory processes of the middle layers of the eye, also called the uveal tract or uvea. See a picture of Uveitis and learn more about the health topic. What is Crohn's Disease?
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