MIGRAINE

Migraine
A migraine is a very painful type of headache. People who get migraines often describe the pain as pulsing or throbbing in one area of the head. During migraines, people are very sensitive to light and sound. They may also become nauseated and vomit.
Migraine is three times more common in women than in men. Some people can tell when they are about to have a migraine because they see flashing lights or zigzag lines or they temporarily lose their vision.
Many things can trigger a migraine. These include
1.Anxiety
2.Stress
3.Lack of food or sleep
4.Exposure to light
5.Hormonal changes (in women)
Doctors used to believe migraines were linked to the opening and narrowing of blood vessels in the head. Now they believe the cause is related to genes that control the activity of some brain cells. Medicines can help prevent migraine attacks or help relieve symptoms of attacks when they happen. For many people, treatments to relieve stress can also help.

What things may set off a migraine?
Certain things that can set off migraines in some people include the following:
Strong or unusual odors, bright lights or loud noises
Changes in weather or altitude
Being tired, stressed or depressed
Changes in sleeping patterns
Certain foods (see the list below), especially those that contain tyramine, sodium nitrate or phenylalanine
Missing meals or fasting
Menstrual periods, birth control pills or hormones
Intense physical activity, including sexual activity
Smoking

Foods that may trigger migraines:
Aged, canned, cured or processed meat, including bologna, game, ham, herring, hot dogs, pepperoni and sausage
Aged cheese
Alcoholic beverages, especially red wine
Aspartame
Avocados
Beans, including pole, broad, lima, Italian, navy, pinto and garbanzo
Brewer's yeast, including fresh yeast coffee cake, donuts and sourdough bread
Caffeine (in excess)
Canned soup or bouillon cubes
Chocolate, cocoa and carob
Cultured dairy products, such as buttermilk and sour cream
Figs
Lentils
Meat tenderizer
Monosodium glutamate (MSG)
Nuts and peanut butter
Onions, except small amounts for flavoring
Papaya
Passion fruit
Pea pods
Pickled, preserved or marinated foods, such as olives and pickles, and some snack foods
Raisins
Red plums
Sauerkraut
Seasoned salt
Snow peas
Soy sauce

Simple steps to head off the pain
Migraines cause pain as real as the pain of injuries — with one difference: Healthy habits and simple nonmedical remedies sometimes stop migraines before they start.By Mayo Clinic staff
Medication is a proven way to treat — and prevent — migraines. But medication is only part of the story. It's also important to take good care of yourself. The same lifestyle choices that promote good health can reduce the frequency and severity of your migraines. In fact, combining lifestyle measures with medication is often the most effective way to handle migraines.
Seek a calm environment
At the first sign of a migraine, retreat from your usual activities if possible.
Turn out the lights. Migraines often increase sensitivity to light and sound. Relax in a dark, quiet room. Sleep if you can.
Try temperature therapy. Apply hot or cold compresses to your head or neck. Ice packs have a numbing effect, which may dull the sensation of pain. Hot packs and heating pads can relax tense muscles. Warm showers or baths may have a similar effect.
Massage painful areas. Apply gentle pressure to your scalp or temples. Alleviate muscle tension with a shoulder or neck massage.
Drink a caffeinated beverage. In small amounts, caffeine can enhance the pain-reducing effects of acetaminophen and aspirin. Be careful, however. Drinking too much caffeine too often can lead to withdrawal headaches later on.
Sleep well
Migraines may keep you from falling asleep or wake you up at night. Likewise, migraines are often triggered by a poor night's sleep. Here's help encouraging sound sleep.
Establish regular sleep hours. Wake up and go to bed at the same time every day — even on weekends. If you nap during the day, keep it short. Naps longer than one hour may interfere with nighttime sleep.
Unwind at the end of the day. Anything that helps you relax can promote better sleep. Listen to soothing music, soak in a warm bath or read a favorite book. But watch what you eat and drink before bedtime. Heavy meals, caffeine, nicotine and alcohol can interfere with sleep.
Minimize distractions. Save your bedroom for sleep and intimacy. Don't watch television or take work materials to bed. Close your bedroom door. Use a fan to muffle distracting noises.
Don't try to sleep. The harder you try to sleep, the more awake you'll feel. If you can't fall asleep, read or do another quiet activity until you become drowsy.
Check your medications. Medications that contain caffeine or other stimulants — including some medications to treat migraines — may interfere with sleep.
Eat wisely
Your eating habits can influence your migraines. Consider the basics:
Be consistent. Eat at about the same time every day.
Don't skip meals. Breakfast is especially important.
Avoid foods that trigger migraines. If you suspect that a certain food — such as aged cheese, avocados or raisins — is triggering your migraines, eliminate it from your diet to see what happens.
Exercise regularly
During physical activity, your body releases certain chemicals that block pain signals to your brain. These chemicals also help alleviate anxiety and depression — conditions that can make migraines worse. If your doctor agrees, choose any exercise you enjoy. Walking, swimming and cycling are often good choices. But it's important to start slowly. Exercising too vigorously can trigger migraines.
Manage stress
Stress and migraines often go hand in hand. You can't avoid daily stress, but you can keep it under control — which can help you prevent migraines.
Simplify your life. Rather than looking for ways to squeeze more activities or chores into the day, find a way to leave some things out.
Manage your time wisely. Update your to-do list every day — both at work and at home. Delegate what you can, and break large projects into manageable chunks.
Take a break. If you feel overwhelmed, a few slow stretches or a quick walk may renew your energy for the task at hand.
Adjust your attitude. Stay positive. If you find yourself thinking, "This can't be done," switch gears. Think instead, "This will be tough. But I can make it work."
Let go. Don't worry about things you can't control.
Relax. Deep breathing from your diaphragm can help you relax. Try to do 20 minutes of deep breathing every day. It may also help to consciously relax your muscles, one group at a time. When you're done, sit quietly for a minute or two.
Keep a migraine diary
A diary may help you determine what triggers your migraines. Note when your migraines start, what you were doing at the time, how long they last and what, if anything, provides relief. Eventually you may be able to prevent migraines by changing patterns in your daily life.
Strive for balance
Living with migraines is a daily challenge. But making healthy lifestyle choices can help. Ask your friends and loved ones for support. If you're feeling anxious or depressed, consider joining a support group or seeking counseling. Believe in your ability to take control of the pain.

Can nonprescription medicines help relieve the pain?
Yes. Nonprescription medicines that can help relieve migraine pain include aspirin, acetaminophen (one brand name: Tylenol), an acetaminophen, aspirin and caffeine combination (one brand name: Excedrin Migraine), ibuprofen (one brand name: Motrin), naproxen (brand name: Aleve), and ketoprofen (brand name: Orudis KT).

What about prescription medicines?
People who have more severe pain may need prescription medicine. A medicine called ergotamine (brand name: Ergomar) can be effective alone or combined with other medicines. Dihydroergotamine (brand names: Migranal, D.H.E. 45) is related to ergotamine and can be helpful.Other prescription medicines for migraines include sumatriptan (brand name: Imitrex), zolmitriptan (brand name: Zomig), naratriptan (brand name: Amerge) rizatriptan (brand name: Maxalt), almotriptan (brand name: Axert), eletriptan (brand name: Relpax) and frovatriptan (brand name: Frova).If the pain won't go away, stronger medicine may be needed, such as a narcotic (brand name: Stadol nasal spray) or medicines that contain a barbiturate. These medicines can be habit-forming and should be used cautiously.

Can medicine help prevent migraines?
Yes. Medicine to prevent migraines may be helpful if your headaches happen more than twice a month or if your headaches make it hard for you to work and function. Examples of medicines used to prevent migraines include propranolol (brand name: Inderal), timolol (brand name: Blocadren), divalproex (brand name: Depakote) and some antidepressants.

acne---> the most serious problem of teens

Acne Overview

Acne is a red, irritating skin rash primarily affecting teenagers and young adults. It can, however, occur at all ages. Typical acne appears in the oil-producing areas of the body-namely, the face, chest, and back. Acne can also occur on the neck and upper arms.

Acne can have a short-term, potentially lasting psychological effect. Decreased self-esteem and self-confidence can lead to social withdrawal and even depression. Left untreated, severe acne can lead to disfiguring scarring, which can itself be difficult to treat.

• Several myths exist about acne.
  
  
  • Acne is not a result of uncleanliness or infrequent washing. In other words, acne does not result from too much dirt on the skin or in the pores. Too much scrubbing may actually make acne worse.
    
    
  • Acne does not come from eating a lot of so-called bad foods such as chocolate or fried foods. No foods cause acne or make it worse.
  
  

  Acne Causes

  Several factors contribute to the development of acne. The primary problem is that the abnormal flaking of cells inside the hair follicle leads to the formation of a plug. The plug can enlarge and even rupture the hair follicle. A ruptured hair follicle spills its contents of oil and debris into the skin where it leads to swelling and causes redness (inflammation).

  • Bacteria that normally live on the skin also play a role in acne development. The bacteria known as Propionibacterium acnes are responsible for causing acne. These bacteria produce substances that cause redness and irritation (inflammation). They also make enzymes, which dissolve the sebum (oil from oil glands in the skin) into irritating substances. These substances also make the inflammation worse.
    
    
  • Certain hormones called androgens are an additional factor in causing acne. Androgens are male hormones that are present in both men and women, but are higher in men. Androgens do two things: First, they enlarge the sebaceous glands in the skin. Second, they cause these glands to increase sebum (oil) production. The increased sebum leads to plug formation and serves as more "food" for the bacteria. Androgens surge at puberty, which is why teens develop armpit and pubic hair, and why boys develop facial hair and deeper voices. This hormonal surge also contributes to the development of acne in teens.
    
    
  • Estrogens, which are the female hormones, actually can help to improve acne in girls. A woman's monthly menstrual cycle is due to changes in the estrogen levels in her body. This is why acne in a female may get better and then get worse as she goes through her monthly cycle. A doctor may recommend acne treatment with birth control pills, which contain the helpful estrogens.
    
    
  • We also now believe that acne can run in some families. This may be due to some genetic factor that has not yet been discovered.

  
  

  Acne lesions: There are 2 major types of acne lesions: noninflammatory and inflammatory. Noninflammatory acne lesions include blackheads (open comedones) and whiteheads (closed comedones). Open and closed comedones along with papules and pustules are referred to as papulopustular acne-a form of inflammatory acne. Nodular acne is the most severe form of inflammatory acne.
  
  

  • Noninflammatory acne: Open comedones result from the enlargement and dilation of a plug that forms from oil and flakes of skin inside the hair follicle.
    
    
    • The hair follicle pore remains open exposing a black plug (known as a blackhead). The dark color is not dirt inside the pore. Instead it is the oil inside the pore, which has become exposed from the outside air.
      
      
    • A closed comedo forms if the hair follicle pore remains closed. The plug in a closed comedo or whitehead is therefore not exposed to the outside air, and no black color develops. The closed comedo simply appears as a tiny, sometimes pink bump in the skin.
    
    
  • Inflammatory acne: Inflammatory acne lesions consist of red blemishes, pimples also called zits (papules, pustules), and larger, deeper swollen tender lesions (nodules).
    
    
    • Papules are closed comedos, which have become red, swollen, and inflamed.
      
      
    • Pustules are closed comedos, which become inflamed and begin to rupture into the skin forming pustular heads of various sizes.
      
      
    • Nodules represent large, tender, swollen acne lesions, which have become intensely inflamed and rupture under the skin. If untreated, these can produce deep scarring.
    
    

    When to Seek Medical Care

    • Acne that does not improve with over-the-counter medicines should be evaluated by a doctor.

    • People with acne that is severe and tender or already scarring should also be seen by a doctor.

    • Women with acne who develop facial hair or have irregular periods require evaluation by a doctor.

    • Anyone with a sudden severe worsening of their acne or acne with fever and severe swelling should see a doctor immediately. These could be signs of a serious skin infection.

    
    

    Acne Treatment

    Self-Care at Home

    • Wash once or twice daily with soap and water to remove excess oil from the skin. An acne cleanser purchased over-the-counter in any drug store can also be helpful. Avoid scrubbing too abrasively because this can actually irritate the skin and cause acne to worsen.

    • Over-the-counter acne medications can be used either at bedtime or during the day. Always follow the directions on any acne product.

    • Many cover-up products are available without a prescription to improve the appearance of blemishes while they have a chance to heal. Most work well and should not worsen acne.

    • Some cosmetics and other skin care products, however, can cause acne to worsen. Look for make-up, cosmetics, and skin care products labeled with the wordnoncomedogenic. This means that it does not cause or worsen acne.

    
    

    Medical Treatment

    Many treatment options are available to treat all forms of acne. Medications are the main treatment for acne and usually work well. Several preparations are available over-the-counter, while others require a prescription from a doctor.

    • Over-the-counter medications: Nonprescription or over-the-counter medications for acne are plentiful and can be effective for milder forms of acne. They come in the form of soaps, washes, and cleansers. 
      
      
      • Many contain benzoyl peroxide, which does two things. First, benzoyl peroxide kills the acne-causing bacteria, which are thought to play a role in acne. Second, benzoyl peroxide can cause drying and flaking off of skin, which can help prevent the pores from becoming plugged. Plugged pores can develop into acne blemishes. 
        
        
      • Scrubbing excessively with any over-the-counter preparation can actually cause acne to worsen by additionally irritating the hair follicles.
      
      
    • Prescription medications: Doctors can prescribe medications when acne becomes moderate to severe or is not controlled by over-the-counter medications. Prescription drugs can be used effectively alone or in combination with other prescription and nonprescription medications. 
      
      
      • Antibiotics: Antibiotics can be effective in treating most inflammatory acne (papules and pustules). They work by killing the bacteria and also by decreasing the redness and swelling seen in the inflammatory forms of acne. 
        
        
        • Antibiotics may be applied to the skin in the form of gels and lotions, or by way of pills. We now know that using a combination of 2 medications together may be very effective in treating acne. Using a topical antibiotic with topical benzoyl peroxide, for example, may prevent bacterial resistance to the antibiotic. Giving an antibiotic by mouth is often needed for acne that is more extensive, red, and tender. 
          
          
        • Antibiotics taken by mouth can be associated with more side effects than if applied to the skin and may interact with other medicines such as birth control pills. Sensitivity to the sun can result in a "badsunburn" in some people who take the antibiotic tetracycline by mouth.
        
        
      • Retinoids: Medicines made from vitamin A (retinoids) are useful in treating several types of acne lesions. Topical retinoids are effective in treating the noninflammatory types of acne (blackheads and whiteheads). 
        
        
        • Topical retinoids (applied directly to the skin) help to open clogged pores by creating a mild peeling effect. Drying of the skin can be a frequent side effect. Oral retinoids are reserved for treating the more extensive nodular type of acne or severe inflammatory acne, which has not responded to other treatments. Oral retinoids not only have a peeling effect but also decrease the production of oil. 
          
          
        • They can also be associated with a number of serious side effects including birth defects in babies of women who become pregnant while taking the medicine. They can also cause elevated blood fats (triglycerides) and damage to the liver. Your doctor may recommend certain blood tests to check for these problems (and to make sure you are not pregnant) if you are given oral retinoids. Depression andsuicidal thoughts have been reported while taking oral retinoids.
        
        

        Next Steps

        Outlook

        The prognosis for most acne is excellent. Most people experience their worst acne during the teen years and grow out of it. The goal in all acne treatment is to prevent scarring. Severe acne left untreated for a long time can result in scarring. The scars can appear as pits (usually on the face) or as big, bumpy scars (usually on the chest and back). The scarring of acne can also be treated. Your doctor can tell you about various ways available to treat acne scars.

        • Pits and depressions left in the skin from acne scarring can be treated with a "skin-sanding" procedure called dermabrasion or by chemical peels.

        • Bumpy scars are often treated with injections of a steroid medicine.

        • Lasers can be used in treating scars but can be expensive.

        
        

        
        

        For More Information

        American Academy of Dermatology

common skin problems

Do you have skin problems?

Is your skin itching, breaking out, covered in a rash, or playing host to strange spots? Skin inflammation, changes in texture or color, and spots may be the result of infection, a chronic skin condition, or contact with an allergen or irritant. You can learn to recognize common adult skin problems. Yet, while many are minor, they may signal something more serious, so always consult a doctor for proper diagnosis.

Shingles (herpes zoster)Shingles results in a rash that can be mildly itchy to intensely painful.

Shingles starts with burning, tingling, or very sensitive skin. A rash of raised dots develops into painful blisters that last about two weeks. Shingles often occurs on the trunk and buttocks, but can appear anywhere. Most people recover, but pain, numbness, and itching linger for many -- and may last for months, years, or the rest of their lives. Treatment with antiviral drugs, steroids, antidepressants, and topical agents can help.

Hives (urticaria)Hives vary in size and may join together to form larger areas.

Hives, a common allergic reaction that looks like welts, are often itchy, stinging, or burning. They may appear anywhere and last minutes or days. Severe hives can cause difficult breathing (get immediate medical attention if this occurs). Medications, foods, or food additives, temperature extremes, and infections like strep throat can cause hives. Removing the trigger often resolves the hives in days or weeks. Antihistamines can provide relief.

PsoriasisSymptoms of psoriasis may be mild (left), or moderate to severe (right).

A non-contagious rash of thick red plaques covered with silvery scales, psoriasis usually affects the scalp, elbows, knees, and lower back. The rash can heal and recur throughout life. The cause of psoriasis is unknown, but skin inflammation may be triggering new skin cells to develop too quickly. Treatments include steroid or retinoid creams, light therapy, and medications.

EczemaThe appearance of eczema can vary from person to person.

Eczema describes several non-contagious conditions where skin is inflamed, red, dry, and itchy. Stress, irritants (like soaps), allergens, and climate can trigger flare-ups though they are not eczema's cause, which is unknown. In adults, eczema often occurs on the elbows and hands, and in "bending" areas, such as inside the elbows. Treatments include cortisone creams, pills, shots, antibiotics, antihistamines, or phototherapy.

RosaceaMen may have more severe symptoms of rosacea; it's more common in women.

Often beginning as a tendency to flush easily, rosacea causes redness on the nose, chin, cheeks, forehead, even in the eyes. The redness may intensify over time, taking on a ruddy appearance. If left untreated, bumps and pus-filled pimples can develop, with the nose and oil glands becoming bulbous. Rosacea treatment includes medications, as well as surgery to remove blood vessels or correct nose disfigurement.

Rash from poisonous plantsA close-up view of a poison ivy rash.

Contact with sap from poison ivy, oak, and sumac causes a rash in most people. It begins with redness and swelling at the contact site, then becomes intensely itchy. Blistering appears within hours or a few days. The typical rash is arranged as a red line on an exposed area, caused by the plant dragging across the skin. The rash usually lasts up to two weeks.

Razor BumpsPeople with curly hair are most affected by razor bumps.

Razor bumps are tiny, irritated bumps that develop after shaving. The sharp edge of closely shaven hair can curl back and grow into the skin, causing irritation and pimples, and even scarring. To minimize razor bumps, take a hot shower before shaving, shave in the direction of hair growth, and don't stretch the skin while shaving. Rinse with cold water, then apply moisturizer.

Skin tagsSkin tags appear most often in women and elderly people.

A skin tag is a small flap of flesh-colored or slightly darker tissue that hangs off the skin by a connecting stalk. Usually found on the neck, chest, back, armpits, under the breasts, or in the groin area, skin tags are not dangerous and usually don't cause pain unless they become irritated by clothing or nearby skin rubbing against them. A doctor can remove a skin tag by cutting, freezing, or burning it off.

AcneAcne is not just for teens: (left) whiteheads; (right) blackhead.

At the heart of acne lies the pimple -- a plug of fat, skin, and keratin. When open, the plug is called a blackhead, closed, a whitehead. Often seen on the face, chest, and back, acne is caused by many things, including hormones. To help control it, keep oily areas clean and don't squeeze pimples (it may cause infection and scars). Only three medications are proven effective for acne treatment: benzoyl peroxide, retinoids, and antibiotics.

Athlete's footInterdigital, or toe web infection, is the most common kind of athlete's foot.

A fungal infection that can cause peeling, redness, itching, burning, and sometimes blisters and sores, athlete's foot is mildly contagious, passed by direct contact or by walking barefoot in areas such as locker rooms, or near pools. The fungi then grow in shoes, especially tight ones without air circulation. It's usually treated with topical antifungal lotions or oral medications for more severe cases.

Moles

Moles can appear anywhere on the skin, alone or in groups.

Usually brown or black, moles can be anywhere on the body, alone or in groups, and generally appear before age 20. Some moles (not all) change slowly over the years, becoming raised, developing hair, and/or changing color. While most are non-cancerous, some moles have a higher risk of becoming cancerous. Have a dermatologist evaluate moles that change, have irregular borders, unusual or uneven color, bleed, or itch.

Age or liver spots (lentigines)

Sun avoidance and the use of sunscreen are key in preventing "age" spots.

These pesky brown spots are not really caused by aging, though they do multiply as you age. They're the result of sun exposure, which is why they tend to appear on areas that get a lot of sun, such as the face, hands, and chest. Bleaching creams, acid peels, and light-based treatments may lessen their appearance. To rule out serious skin conditions such as melanoma, see a dermatologist for proper identification.

Pityriasis Rosea

Pityriasis rosea is most often seen between the ages of 10 and 35.

A harmless rash, pityriasis rosea usually begins with a single, scaly pink patch with a raised border. Days to weeks later, salmon-colored ovals appear on the arms, legs, back, chest, and abdomen, and sometimes the neck. Patches on the back may appear "Christmas tree" shaped. The rash, whose cause is unknown, usually doesn't itch, and often goes away in 6-8 weeks without treatment.

Melasma ('pregnancy mask')

'Pregnancy mask' occurs in half of all women during pregnancy.

Melasma (or chloasma) is characterized by tan or brown patches on the cheeks, nose, forehead, and chin. Although usually called the "pregnancy mask," men can also develop it. Melasma may go away after pregnancy but, if it persists, can be treated with prescription creams and over-the-counter products. Use a sunscreen at all times if you have melasma, as sunlight worsens the condition.

Digestive Disease Myths - Common Misconceptions

digestive disease m

yths

Researchers have o

nly r

ecently begun to underst

and the many, often complex, diseases that affect the digestive system.

 Accordingly, people ar

e gradually replacing folklore, ol

d wives' tales, 

and rumors about the

 causes and treatments of digestive diseases with accurat

e, up-to-date

 information. But misunderstandings still exist,

 and, while some folklore is harmless, some can be

 dangerous if it keeps

 a person from correctl

y preventing or treating an illness. 

Myth #

 1

 Ulcers: Spicy food and stress cause st

omach ulcers.

False - The truth is, the ma

jority of stomach ulcers are caused either by infection with a bacterium call

ed Helicobacter pylori (H. p

ylori) or by use of pain medications such as aspirin, ibuprofen, 

or naproxen, the so-called nonsteroidal antiinflammatory drugs

 (NSAIDs). Mos

t H. pylori-related ulcers can be cured with antibiotics. NSAID-induced ulcers can be cured w

ith time, stomach-protective medications, antacids, and avoidance of NSAIDs. Now that it is

 appreciated that H. pylori and NSAIDs are th

e cause of most ulcers and patients are being managed appropriately, t

he ulcers that are com

ing to medical attention are increasingly likely to be unrelated to H. pylori or NSAIDs. Spic

y food and stress (except when associated with extreme medical condit

ions) may aggravate ulcer symptoms in some people, but they do not cau

se ulcers. Ulcers can also be ca

used by cancer.

cigarette

 helps relieve heartburn.

False - Actually, cigarette smoking may contribute to heartburn. Heartburn occurs

 when the lower esophageal sphincter (LES) - a muscle between the esophagus and stomach - relaxes, allowing the acidic contents of the stomach to splash 

back (reflux) into the esophagus. People who smoke more frequently have inflammation of the esophagus (esophagitis), presumably caused by 

increased reflux of acid, that is the basis of heartbu

rn. The increased reflux is believed to be due to the fact that cigarette smoking causes the LES to relax

Myth # 3 Celiac Disease: Celiac disease

 is a rare childhood disease.

False - Celiac disease affects both children and adults. A

bout 1 in 200 people in the United States have the genetic predisposition for celiac disease althoug

h not all of them have the disease. Sometimes celiac disease first causes symptoms during childhood, usually diarrhe

a, growth failure, and failure to thrive. But the disease can also first cause symptoms in adults of any a

ge. These symptoms may be vague and therefore attributed to other conditions. Symptoms can in

clude bloating and abdominal distention, flatulence, diarrhea, and abdominal pain due to the involv

ement of the small intestine as well as skin rash, anemia, and thinning of the bones (osteoporosis) due 

to malabsorption of nutrients by the diseased intestine. Celiac disease may cause such nonsp

ecific symptoms for several years before being correctly diagnosed and treated.

People with celiac disease should not eat any

 foods containing gluten, a protein in wheat, rye, and barley, whether they have symptoms or n

ot. In celiac disease, gluten provokes an inflammatory reaction by the body that destroys the lini

ng of the small intestine, which interferes with the absorption of nutrients. Even a small amount of glute

n can cause damage, and sometimes no symptoms will be apparent.

Myth # 4 Bowel Regularity: Bowel regularity means a bowel movement every day.

False - The frequency of bowel movements among normal, healthy people varies from three a day to t

hree a week, and some perfectly healthy people fall outside both ends of this range. Nevertheless, even three bowel movements a day can be abnormal in someone who usually has one bowel movement a day. People with irritable bowel syndrome (IBS) may have fluctuating numbers of stools each day as well as fluctuating consistency of their stools.

Myth # 5 Constipation: Habitual use of enemas to treat constipation is harmless.

False? - It is not clear whether or not habitual use of enemas is harmless since there has been very little study of the effects of enemas or laxatives over the long term. Early studies showed that laxatives might injure the colon if taken chronically by impairing contraction of the colonic muscles, and this finding was extrapolated to include enemas. The data from the studies is not strong, however. In fact, some physicians feel that enemas are preferred over laxatives since they are a more "natural" means of stimulating a bowel movement. (Enemas mimic a large amount of stool in the rectum, the usual stimulus for a bowel movement.) An ongoing need for enemas is not normal; you should see a doctor if you find yourself relying on them or any other medication to have a bowel movement.

Myth # 6 Diverticulosis: Diverticulosis is an uncommon and serious problem.

False - Actually, the majority of Americans over age 60 have diverticulosis, but only a small percentage have symptoms or complications. Diverticulosis is a condition in which little sacs or out-pouchings, called diverticula, develop in the wall of the colon. These sacs tend to appear and increase in number as individuals age. Most people have no symptoms and learn that they have diverticula after an X-ray or intestinal examination (for example, colonoscopy or barium enema) that is being done for a purpose unrelated to the diverticulosis. Less than 10 per cent of people with diverticulosis ever develop complications such as infection (diverticulitis), bleeding, or perforation of the colon.

Myth # 7 Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease): Inflammatory bowel disease is caused by psychological problems.

False - Inflammatory bowel disease is the general name for two diseases that cause inflammation in the intestines, Crohn's disease and ulcerative colitis. The cause of the disease is unknown, but researchers speculate that it may result from a virus or bacteria interacting with the body's immune system. No evidence has been found to support the theory that inflammatory bowel disease is caused by tension, anxiety, or any other psychological factor or disorder, although these can aggravate the discomfort caused by the disease.

Myth # 8 Cirrhosis: Cirrhosis is only caused by alcoholism.

False - Alcoholism is just one of many causes of cirrhosis. Cirrhosis is scarring and decreased function of the liver. In the United States, alcohol causes less than one-half of cirrhosis cases. The remaining cases are from diseases that cause liver damage. For example, in children, cirrhosis may result from cystic fibrosis, alpha-1 antitrypsin deficiency, biliary atresia, glycogen storage diseases, and other rare diseases. In adults, cirrhosis may be caused by hepatitis B or C, primary biliary cirrhosis, diseases of abnormal storage of metals (like iron or copper) in the body, severe reactions to prescription drugs, or injury to the ducts that drain bile from the liver. In adults, cirrhosis can also be caused by nonalcoholic steatohepatitis (NASH), which is becoming the most common liver disease in the United States, affecting 2 to 5 percent of Americans. NASH is associated with the increasing prevalence of obesity and diabetes.

Myth # 9 Ostomy Surgery: After ostomy surgery, men become impotent, and women have impaired sexual function and are unable to become pregnant.

False - Ostomy surgery does not, in general, interfere with a person's sexual or reproductive capabilities. Ostomy surgery is a procedure in which the diseased part of the small or large intestine is removed and the remaining intestine is attached to an opening in the abdomen. Stool is collected in a bag taped to the skin over the opening. Alternatively, an internal pouch that collects the stool may be formed from a portion of the intestine. The pouch then can be emptied by insertion of a catheter at regular intervals.

Although some men who have had radical ostomy surgery for cancer lose the ability to achieve and sustain an erection, most men do not, or, if they do, it is temporary. This is caused by damage to the nerves that supply the penis. If erectile dysfunction persists, a variety of solutions are available. A urologist, a doctor who specializes in such problems, can help find the best solution.

In women, ostomy surgery does not damage sexual or reproductive organs, so it is not a direct cause of sexual problems or sterility. Factors such as pain and the adjustment to a new body image may create temporary sexual problems, but they can usually be resolved with time and, in some cases, counseling. Unless a woman has had a hysterectomy to remove her uterus, she can still bear children.