What are risk factors?
Anyone can develop blood in the urine.
Age: Many men in the 5th decade of life develop and enlarged prostate and have blood in urine
Females generally tend to have hematuria in urine from a UTI
Family history may predispose one to kidney stones which may lead to blood in urine.
Medications like aspirin and penicillin can cause blood in the urine.
Athletes who are long distance runners or joggers often develop hematuria.
Diagnosis
After a complete history and physical examination, hematuria work up depends on the suspected cause.
Urine analysis can determine if there is blood, infection, or a stone. Urine analyses is not specific for diagnosis and some type of radiological study is usually required.
Imaging with CT scan, MRI, or ultrasound can help look at the urinary tract.
Sometimes a long flexible camera (cystoscope) is passed from the penis or vagina into the urethra and up the ureter. The camera can help visualize structures and biopsy can be obtained.
In a few cases the diagnosis of hematuria may not be evident. This may occur if one has had a prior exposure to a drug or an environmental toxin.
In elderly individuals, the cause of hematuria is almost always investigated to rule out a cancer.
Showing posts with label CT scan. Show all posts
Showing posts with label CT scan. Show all posts
Monday, June 8, 2009
Sunday, June 7, 2009
Blood Clots: part 3
What causes blood clots in the veins?
There are many reasons why blood clots can form in veins. These include
- Prolonged immobility (after surgery)
- Long airplane ride
- Taking the birth control pill
- Trauma or fractures of leg(s)
- Injury to veins
- Cancer
- Stroke- which has caused one to become bed ridden
- After any surgery- especially hip and knee
- Obesity
- Congestive heart failure
- Pregnancy or just after delivery
- Inherited blood disorders
- Prior blood clot –there is increased chance of a
second clot if one has had a previous blood clot
Are blood clots dangerous?
Most definitely. Any time you have one of the above symptoms; one should go and see a doctor. Blood clots in veins have a high tendency to break off and migrate to the lungs where they can cause serious problem’s including death.
How can blood clots in veins be detected?
Your physician will first examine you and order the most appropriate tests. The first test to detect blood clots in all cases is an ultrasound.
Doppler ultrasound is a painless test that takes a few minutes and can easily detect the presence of blood clots in arm and leg veins. However, if blood clots are located in the chest, abdomen or pelvis, Ultrasound is not good enough.
MRI: This non invasive test is also excellent for evaluating presence of blood clots. The test does not use radiation but is slightly more expensive. It is useful for detection of blood clots almost anywhere in the body, but is not the first test of choice.
Venogram: In the old days Venogram was used to look for blood clots. However this test is rarely used to day because of availability of US and MRI. Venogram requires use of a dye and radiation.
CT scan: The newer CT scans can easily identify presence of clots in the lungs. However, CT scans are not routinely used to detect blood clots as the initial test. CT scan requires exposure to radiation and use of an iodinated dye.
There are many reasons why blood clots can form in veins. These include
- Prolonged immobility (after surgery)
- Long airplane ride
- Taking the birth control pill
- Trauma or fractures of leg(s)
- Injury to veins
- Cancer
- Stroke- which has caused one to become bed ridden
- After any surgery- especially hip and knee
- Obesity
- Congestive heart failure
- Pregnancy or just after delivery
- Inherited blood disorders
- Prior blood clot –there is increased chance of a
second clot if one has had a previous blood clot
Are blood clots dangerous?
Most definitely. Any time you have one of the above symptoms; one should go and see a doctor. Blood clots in veins have a high tendency to break off and migrate to the lungs where they can cause serious problem’s including death.
How can blood clots in veins be detected?
Your physician will first examine you and order the most appropriate tests. The first test to detect blood clots in all cases is an ultrasound.
Doppler ultrasound is a painless test that takes a few minutes and can easily detect the presence of blood clots in arm and leg veins. However, if blood clots are located in the chest, abdomen or pelvis, Ultrasound is not good enough.
MRI: This non invasive test is also excellent for evaluating presence of blood clots. The test does not use radiation but is slightly more expensive. It is useful for detection of blood clots almost anywhere in the body, but is not the first test of choice.
Venogram: In the old days Venogram was used to look for blood clots. However this test is rarely used to day because of availability of US and MRI. Venogram requires use of a dye and radiation.
CT scan: The newer CT scans can easily identify presence of clots in the lungs. However, CT scans are not routinely used to detect blood clots as the initial test. CT scan requires exposure to radiation and use of an iodinated dye.
Wednesday, May 6, 2009
Irritable bowel syndrome 101 part 3
Tests for IBS
Common tests which are performed in patients suspected of IBS include:
Sigmoidoscopy- a test which uses a flexible scope passed through the rectum and examines lower colon
Colonoscopy uses a flexible scope with a camera but can examine the entire colon.
CT scan is used to examine the entire abdomen and pelvis. It does use radiation and a dye
Because symptoms of IBS are often similar to lactose intolerance, many individuals undergo a breath test to rule out it out.
The other disorder that is very similar in presentation to IBS is celiac disease. Thus, one may need to undergo some types of blood tests to determine presence of celiac disease
Affect on lifestyle
IBS is not life threatening but can interfere with personal life, relationships and friends. One becomes preoccupied with food and develops certain degree of paranoia. This often leads to a disturbed personality, anger, and isolation. One can even develop malnourishment if proper nutrients are not consumed.
Most patients seek help when symptoms affect quality of life. Because of the vague symptoms, the diagnosis of IBS is always delayed. However, even when the diagnosis is made, treatment is not always effective.
Pathophysiology
Why IBS occurs is a mystery. There are countless theories and speculations but the real reason for IBS is not known. The most likely factors that lead to development of IBS include disordered gut motility, increase sensitivity of intestines to food or chemicals, and increased contractions of gut. When these factors are combined, they can lead to constipation, diarrhea, abdominal bloating, nausea, and abnormal gas expulsion. Most individuals who have IBS are very sensitive to wheat and dairy products leading to rapid diarrhea, abdominal cramps, and gas production.
In each and every case, the symptoms can be very confusing and doctors generally try to rule out the most common abdominal disorders with radiological tests.
In all cases, IBS is a diagnosis of exclusion and often it takes several months to a year to make the diagnosis
Common tests which are performed in patients suspected of IBS include:
Sigmoidoscopy- a test which uses a flexible scope passed through the rectum and examines lower colon
Colonoscopy uses a flexible scope with a camera but can examine the entire colon.
CT scan is used to examine the entire abdomen and pelvis. It does use radiation and a dye
Because symptoms of IBS are often similar to lactose intolerance, many individuals undergo a breath test to rule out it out.
The other disorder that is very similar in presentation to IBS is celiac disease. Thus, one may need to undergo some types of blood tests to determine presence of celiac disease
Affect on lifestyle
IBS is not life threatening but can interfere with personal life, relationships and friends. One becomes preoccupied with food and develops certain degree of paranoia. This often leads to a disturbed personality, anger, and isolation. One can even develop malnourishment if proper nutrients are not consumed.
Most patients seek help when symptoms affect quality of life. Because of the vague symptoms, the diagnosis of IBS is always delayed. However, even when the diagnosis is made, treatment is not always effective.
Pathophysiology
Why IBS occurs is a mystery. There are countless theories and speculations but the real reason for IBS is not known. The most likely factors that lead to development of IBS include disordered gut motility, increase sensitivity of intestines to food or chemicals, and increased contractions of gut. When these factors are combined, they can lead to constipation, diarrhea, abdominal bloating, nausea, and abnormal gas expulsion. Most individuals who have IBS are very sensitive to wheat and dairy products leading to rapid diarrhea, abdominal cramps, and gas production.
In each and every case, the symptoms can be very confusing and doctors generally try to rule out the most common abdominal disorders with radiological tests.
In all cases, IBS is a diagnosis of exclusion and often it takes several months to a year to make the diagnosis
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