Cholecystitis

Cholecystitis refers to severe abdominal pain associated with gallbladder inflammation or gallstones. Acute Cholecystitis can manifest as sharp cramping pain in the right upper quadrant of the abdomen. This pain can spread to the back or below the right shoulder blade. It usually appears after a fatty meal. Cholecystitis might also lead to nausea and vomiting and often jaundice. The person suffering Cholecystitis might notice clay colored stools and fever. Diagnostic tests that are prescribed to detect this condition are Liver function test, abdominal ultrasound and Endoscopy.

In many cases, Cholecystitis can clear on its own, with the right low fat diet and antibiotics. But in other cases, Cholecystectomy may be done to remove the gallbladder. Acute Cholecystitis needs to be treated urgently lest it lead to complications such as a perforated gallbladder or gangrenous Cholecystitis where the gallbladder tissue dies. On the other hand, cholangitis involves infection of the bile ducts either due to biliary obstruction or bacterial infection.

Lead poisoning

Lead poisoning occurs when there is increased level of lead inside the body. Lead is toxic and can lead to many health problems such as headache, anemia, abdominal pain and irritability. Over time, lead poisoning can result in kidney failure, hypertension, learning difficulties, lethargy and behavioral problems. Children are at risk for lead poisoning when they are in contact with products containing lead. X-rays, blood count and CT or MRI of brain can help in identifying lead poisoning.

Lead poisoning in adults has often been traced to the use of lead based glazes on potteries and contamination of herbal medicines. Sometimes lead pipes in older homes can leach lead into water. It is safe to let the water run for a few seconds before using the water for consumption. The more time water has been sitting in the pipes, the more lead it may contain. Again hot water may contain more lead than cold water. In adults, symptoms of lead poisoning are seen when the lead level in the blood exceeds 80 µg/dL for weeks.

Lead exposure is measured in micrograms per deciliter of blood (µg/dL). The following is a guide to the standards on lead exposure set by the CDC (Centers for Disease Control and Prevention):

• 0 µg/dL : Even at birth, all people have some lead in their blood. However no level of exposure is deemed safe for children.
  
  
• 1.0 — 1.3 µg/dL : Average blood lead level among children ages 1-5 in the US
  
  
• 3.5 µg/dL : The CDC is considering using this level as a new "reference value" to identify children under age six with elevated blood lead levels. The threshold is lowered periodically to reflect new data from a national health and nutritional survey.
  
  
• 5 µg/dL : The CDC's current reference level for an elevated childhood blood level that warrants public health action, close monitoring or case management. Some 500,000 U.S. children are at or above this level, which some states define as lead poisoning.
  
  
• 10 µg/dL : Children who reach this threshold require closer attention and action to limit further lead exposure. Many states conduct inspections of the poisoned child's living environment to identify exposure sources. Research shows that a blood lead level of 10 µg/dL can lower IQ by 4 to 6 points on average.
  
  
• 45 µg/dL : Poisoning that may require hospitalization and chelation drug treatment, which helps the body to excrete lead. The drugs aren't considered effective for children with lower blood lead levels.
  
  
• >70 µg/dL: Left unchecked, acute lead poisoning can cause seizures, coma and death.
  
  

High levels of lead in the blood may require Chelation Therapy (treatment with chemical agents that bind to the heavy metal lead which can be excreted through urine). There are 4 agents :
Edetate Calcium Disodium (EDTA calcium) and Dimercaprol (BAL) are given through injections
Succimer (Chemet) and Penicillamine (Cuprimine, Depen) are taken orally.

Colonoscopy

Colonoscopy allows the doctor to look into the interior lining of the large intestine. Through this procedure, the doctor is able to detect inflamed tissue, abnormal growths, polyps, tumors and ulcers. Early signs of cancer in the colon and the rectum can also be detected through colonoscopy. This procedure is also used to study unexplained changes in bowel habits, to evaluate symptoms of abdominal pain, rectal bleeding and sudden weight loss. The colonoscope is a thin flexible instrument whose length ranges from 48 inches to 72 inches. A small video camera is attached to the colonoscope so that photographic, electronic or videotaped images of the large intestine can be taken. Colonoscope is used to view the entire colon as well as a small portion of the lower small intestine.

The colon should be completely empty for colonoscopy to be thorough and safe. The liquid diet should be clear of any food colorings. It should be fat free. The colonoscope is gradually inserted into the rectum and slowly guided into the colon. The scope transmits an image of the inside of the colon onto a video screen so that the doctor can carefully examine the lining of the colon. The scope blows air into the colon and inflates it so that the doctor has a better view of the colon. During the procedure, the doctor is able to remove abnormal growths like polyp in the colon.

• Colonoscopy aids the doctor to remove most polyps without abdominal surgery.
  
• Colonoscopy is more accurate than a routine x ray to detect polyps, tumors, ulcers and cancers at early stage.
  
• Colonoscopy is done most often to investigate and find the cause of blood in the stool, abdominal pain and diarrhea.
  
• Certain patients with previous history of polyps or colon cancer, patients with family history of particular malignancies, colon problems are advised to have periodic Colonoscopy because they are at greater risk of polyps or colon cancer.

Virtual colonoscopy: Here the technique that is adopted uses a CAT scan to construct virtual images of the colon. These images are similar to the views of the colon obtained by direct observation through colonoscopy. However, virtual colonoscopy cannot find small polyps which are less than 5 mm in size. These can be seen by the traditional colonoscopy. Virtual colonoscopy is not as accurate as colonoscopy in finding cancers or pre-malignant lesions that are not protruding. Virtual colonoscopy also cannot remove polyps.