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If constipation is present, and there is difficulty in passing hard, dry stools, laxatives may be used as a temporary measure to restore the normal bowel function.

However, the number of bowel actions a day (or week) can vary enormously. Bottle-fed babies will often go many days before having a bowel action. If these actions are soft and normal in consistency, baby is not necessarily constipated and does not need laxatives.

In hot weather, baby may lose an enormous amount of fluid. If this is not made up, either in the form of boiled water or milk, or other fluid-containing products, a child will soon become partially dehydrated, and constipation can ensue. The best way to get back to normal is to increase the fluid intake.

Therefore, water may be the best laxative or cure for apparent constipation. That’s right. Also it’s necessary to try to find out why bowel actions arc hard and dry and infrequent before resorting to laxatives. For example, if baby has a tear at the back entrance, there’s a tendency to “hold back” (because a bowel action hurts). The baby becomes constipated, not through any real fault of the bowel system, but merely because it’s more comfortable. Treating the tear is more important than rushing to the laxative bottle.

The doctor may prescribe a local anesthetic ointment to be applied.

Sometimes it is desirable to help nature along. The simple method of inserting a glycerin suppository into the back passage will often produce an effective bowel action from 15 to 45 minutes later. The suppository should be well covered with lanoline or petroleum jelly (and some added locally) to facilitate easy entry. Push gently, and avoid undue pressure that may produce discomfort. It is often necessary to hold the folds of the buttocks together for several minutes to check the suppository slipping out. The suppository dissolves, mixes with the hardened fecal mass, and this is all expelled in the form of a fairly normal bowel action.

The suppository, of course, is used once and once only. (Some mothers believe a suppository is pushed in and out a few times, wiped, and then returned to the bottle for future use! This sounds incredible, but it happens.)

In acute constipation, a simple enema may sometimes be needed. Experience is usually necessary for this, and a trained sister may have to do it. Very simple forms of enemas, commercially prepared, are available today that make this much easier to perform.

Often, adding products to the dietary intake will correct constipation problems. Adequate fluids between feeds can be curative. Increasing the sugar content of the milk may assist.

Prune juice and molasses are also advocated by some, and can be effective as baby gets older. Adding pureed fruits to the diet of older children may be effective (such as pureed prunes and plums). Commercial oral preparations are often used. Medical advice should be sought before any long-term use of these laxatives is started.

Primary Hyperparathyroidism

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What is Primary Hyperparathyroidism?

The parathyroid glands secrete excess hormone for unknown reasons. The implications are symptoms due to renal calculi (kidney stones) formed from the persistently high levels of calcium in the blood and being excreted through the kidneys, plus bone disease as a result of the continual removal of calcium.

Generally, this is fairly rare. It may occur in the 30-60-years age segment, being more common in women. Often the disorder has been present for many years before it is detected. Frequently the diagnosis is made by chance, the patient having undergone blood tests (probably the multichannel auto-analysers now widely used in every city). A reading showing a high serum calcium level and low serum phosphate is strongly indicative of this disorder.

Primary Hyperparathyroidism Symptoms

When they do occur, they usually take place when a kidney stone produces symptoms. This may cause intense pain (renal colic), or blood in the urine, or kidney infection, either singly or collectively. In fact, about 5 per cent of cases of kidney stones are due to this disorder, and the figure rises to about 1 5 per cent of those with recurring stones. The condition may present with another batch of symptoms. These might include gradual weight loss, weakness, feeling drowsy or thirsty, and passing excessive amounts of urine. Mental changes may be present, with anxiety and depression being marked features. There may be unexplained dyspepsia with peptic ulceration.

Another symptom is pains in bones indicating that activity is taking place. In fact, the patient may come along with a pathological fracture, possibly of the vertebral bones. The diagnosis is confirmed by the blood serum tests a high calcium level and a low phosphorus reading.

Primary Hyperparathyroidism Treatment

Acute attacks are treated by endeavouring to lower the high serum-calcium levels as quickly as possible. This may be achieved by phosphate infusions or by a method called chelation. Primary hyperparathyroidism is then treated surgically by removing the glands. Often the four are removed, but part of one is left behind to continue with the normal activity of the glands. If’ all glands are removed, post-operative tetany may ensue, this is a serious complication.

Usually there are striking improvements following this form of treatment as far as the bone disease is concerned. However, renal damage may not show much benefit. Renal function may continue to deteriorate, and elevated blood pressure may result.

Dirt Eating

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What is Dirt Eating?

Pica is a disorder in which non-nutritious substances (for instance, dirt) are largely included as part of the patient’s diet. Pica is Latin for magpie. But just as a magpie is claimed to go for all manner of strange objects, dirt eating (pica) is similar. By definition it’s an abnormal craving to eat substances not fit for food, such as wood, lead pencils or chalk. It’s claimed to be more common among children and pregnant women.

The range of items eaten is truly remarkable, and in recent years many articles have appeared in the world medical journals attesting to the variety of items devoured.

One person munched up 9,000 g of ice a day. She wore several sets of teeth out munching the hard stuff. Another woman ate at least two pages of the evening newspaper regularly. (She finally had a bowel obstruction that nearly killed her. Emergency surgery saved her.) Some women have a craving for food and will cat anything within their grasp. Putty has been popular with some. Clay and chalk are also commonly eaten.

Dirt Eating Treatment

Fortunately the remedy is often surprisingly simple. A full examination by the doctor is necessary. Occasionally there may be an underlying condition, and occasionally there is a psychiatric hysterical element. But many will respond well to an adjustment of the iron intake each day. It seems many are anemic, and when this is cured, the symptoms likewise vanish. Remarkable, isn’t it? A simple remedy for a really strange disorder.

Hay Fever

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Hay fever is like asthma, is an allergy-type disorder. It may occur during the first twelve months, but is more common after one or two years. It may come on at certain times, such as spring and early summer—hence its common name, “hay fever” or “spring fever”—or it may come on any time. During spring, it is commonly due to the inhalation of pollens from flowering grasses and trees. But there are lots of other causes, similar to those that can predispose some children to asthma, like feathers, material from animals, commonly household ones, house dust, kapok, and whatnot.

Hay Fever Symptoms

Little Cameron will suddenly complain of itchy eyes, or ears, or his throat is parched and dry and irritable. There may be a stuffed-up nose, and his nostrils may discharge a thin, clear, watery fluid. Often he starts sneezing, especially in the morning.

I suppose many mothers mistake this for the start of another cold. True. In the early stages the symptoms are very similar. Sometimes the recurring nature may predispose the child to nosebleeds. There may be headaches and bouts of sleepiness. Attacks may come on at irregular intervals, or they may obviously be related to certain events— flowering shrubs in the backyard for instance, or when the wattle blooms. Often the eyes redden, the lids swell and tears roll down the cheeks.

Hay Fever Treatment

There are many methods. Frequently, once the diagnosis has been confirmed by the doctor, antihistamines can give good relief. These come in mixture form for small children or tablets for older ones. But these make the child awfully tired and sleepy.

They certainly do. If the child is trying to study, ride a bike to school, or is involved with gear at a school that could be dangerous, then some other form of medication may be more desirable. But a course of mild antihistamines can offer relief. Minimal amounts would be given for the shortest possible period of time to gain relief.

Non-sedating antihistamine tablets and syrup are now available that similarly relieve symptoms but do not cause tiredness or lack of coordination. What else is available?

The drug ephedrine has often been used but this too has largely been replaced by newer products.

In severe cases, beclamethasone opionate, the aerosol spray similar to one used for asthmatics, is effective when inhaled into the nostrils regularly. It takes 10-14 days of regular use for it to have some effective.

Sodium cromoglycate, a powder which led into the nostrils by a special device, can be used regularly and can often give good preventative tip also. These products are readily available, but should be ordered by the doctor and given under general supervision. Other sprays like “Tobispray” are good for instant relief. These clear the nostrils and head and the patient will feel much better. Guard against overuse of any of these products.

What about using nasal drops to help relieve symptoms? Certain so-called decongestant drops, from time to time, give temporary relief. Once more, overuse of these is unable. In turn it can aggravate the condition from which relief is being given.

A series of injections aimed at increasing the patient’s resistance to these allergens may be given from a special extract prepared specifically for the patient. It takes regular weekly injections for many months.

Some doctors use an oral drop extract. But sometimes doctors believe this is worthwhile. It is probably of most value when it is not possible to remove the cause of the attacks, and symptoms are severe and disabling. At least it’s another form of therapy and worth thinking about if other measures fail.

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