Heart Failure

Heart failure is associated with a pathologically reduced pumping capacity of the heart. Here you can find out more about symptoms, causes, and therapy for heart failure. Heart failure, also commonly known as heart failure or cardiac muscle weakness, is a disease of the heart that is associated with a pathologically reduced pumping capacity. The heart is too weak to pump enough blood around the body. Heart failure occurs less often, even with normal or even increased pumping capacity – namely when the heart can only insufficiently fill with blood. In any case, weakness, tiredness, and shortness of breath are the result. Heart failure often develops over a long period of time (chronic heart failure), but it can also appear suddenly as acute heart failure, for example in the event of a heart attack. Heart failure is divided into different degrees of severity depending on the severity of the symptoms.

The Cardiac Output at a Glance

The heart with its pumping function is the motor for blood circulation. The incoming (used up) blood from the veins reaches the right ventricle via the right atrium. From there it goes on to the lungs. In the lungs, the blood is enriched with fresh oxygen and returns to the heart, but this time to the left heart area. It flows through the left atrium into the left ventricle and from there is pumped into the arteries. If the right ventricle is affected by heart failure, cardiologists speak of right ventricular failure and the left ventricle of left ventricular failure. If both heart chambers are affected by heart failure, this is a global insufficiency. The symptoms vary depending on the type of heart failure.

Doctors separate the symptoms of heart failure into those of right heart failure and those of left heart failure.

Symptoms Of Left Heart Failure

In left heart failure, the left heart can no longer pump enough blood into the body. This results in reduced resilience and physical weakness, and rarely too low blood pressure.

In addition, the blood backs up in the lungs. Sometimes the liquid components of the blood (especially water) are pressed out of the blood vessels into the lungs: water accumulates in the lungs, causing pulmonary edema. This leads to shortness of breath and a cough. As the disease progresses, breathing difficulties increase so much that those affected can hardly breathe while lying down. This is why they typically sleep with their upper bodies elevated or sitting completely. The following usually applies: the higher the mountain of pillows at the head end, the more pronounced the left heart failure. Long-term and severe blood backlog in the lungs can also develop right heart failure and global insufficiency.

Symptoms of Right Heart Failure

Right heart failure can develop from left heart failure, but it can also develop without a previous left heart failure. The latter is the case when the right heart is no longer able to take in enough blood from the body and pump it into the pulmonary circulation. In this case, the blood backs up in the venous system of the body. This increases the pressure in the veins.

The following symptoms are typical for right heart failure:

Heavy and swollen legs due to edema: With strong and sustained pressure, the liquid components of the blood are pressed out of the blood vessels into the body tissue: water is stored in the tissue, causing edema. This water retention occurs primarily in the lower legs, ankles, and feet. The consequences are, among other things, heavy and swollen legs. Typically, stockings or socks leave dents in the skin. As the disease progresses, the blood can also back up in the neck veins and in the veins at the base of the tongue. Thick vein cords are then visible on the neck and base of the tongue.

Frequent nocturnal urination: The stored water often leads to weight gain. Another typical symptom is urination at night (nocturia). Right heart failure patients have to go to the toilet several times during the night. The reason for this is as follows: When the body is upright, there is a large gap between the legs and the heart, not when sleeping in a horizontal position. When lying down, the heart can transport the stored water to the kidneys more easily. From there it is excreted in the urine. Furthermore, the kidneys are better supplied with blood when the body is in a horizontal position, which makes their work easier and also improves the nocturnal excretory function.

Body water retention: With pronounced and persistent right heart failure, the water is not only deposited in the legs and feet. The backlog of blood in front of the heart leads to generally increased venous pressure and further water retention. If water collects in the abdominal cavity, doctors speak of ascites. Often the blood also backs up in the abdominal organs. This leads to an enlarged and painful liver (congested liver), congestive gastritis develops in the stomach with loss of appetite and flatulence. If water collects in the gap between the pleural leaves (i.e. between the lungs and the pleura or pleura), pleural effusion occurs. This causes shortness of breath and throat irritation.

Heart Failure

Symptoms Of Global Insufficiency

If both parts of the heart are affected, doctors speak of a global heart muscle weakness, global insufficiency. Global insufficiency combines symptoms of left and right heart failure.

Heart shock – the most dangerous form of heart failure

The most dangerous form of heart failure is cardiac shock, medically known as cardiogenic shock. Sufferers of cardiogenic shock have severe shortness of breath and are cold sweaty, the hands and feet are cool and the pulse is racing. In the worst case, the consciousness becomes cloudy.

Acute and chronic heart failure

Doctors differentiate between acute and chronic cardiac weakness according to the course. Acute heart failure develops over hours to days. The chronic form, on the other hand, develops over the course of months to years. H4: Classification of heart failure according to NYHA Heart failure is differentiated depending on its severity. Doctors differentiate between two classifications, the American Heart Association (AHA) classification and the New York Heart Association (NYHA) classification. The NYHA classification is more common in Germany. According to NYHA there are 4 stages of heart failure:

    • Stage I: no complaints, normal physical resilience
    • Stage II: discomfort with heavy physical exertion
    • Stage III: complaints even with light physical exertion
    • Stage IV: discomfort in all physical activities and at rest.

Causes

The causes of heart failure are complex. The heart’s pumping capacity depends on several factors: the strength of the heart muscle, the heart rate, and the resistance in the bloodstream. Disorders of all three factors can be responsible for heart failure.

The following diseases can cause heart failure:

    • constricted coronary arteries (coronary heart disease, short CHD)
    • Heart attack, heart valve defects (for example mitral valve insufficiency), cardiac arrhythmias as well as heart inflammation and pericardial effusions
    • Hypertension (high blood pressure) and increased blood volume in the body
    • hormonal diseases (e.g. hyperthyroidism)
    • metabolic diseases (e.g. overweight or obesity)
    • severe anemia or an increased blood requirement with a high fever
    • Vitamin D deficiency.

Examination

The doctor makes the diagnosis of heart failure based on the symptoms and previous or concomitant illnesses. Laboratory examinations, an ultrasound examination of the heart, and a cardiac catheter examination are usually carried out to ensure this. X-ray examinations and magnetic resonance imaging (MRI) also help with the diagnosis.

Treatment

Drug therapy for heart failure aims to treat the underlying disease. In addition, drugs that relieve the strain on the heart or strengthen the heart muscles are used. The following recommendations apply to the severity levels according to NYHA:

    • Stage I: ACE inhibitors such as captopril, enalapril, lisinopril, fosinopril, trandolapril or ramipril. If ACE inhibitors are not tolerated, drugs from the group of AT1 receptor antagonists such as candesartan, losartan and valsartan are an alternative.
    • Stages II to IV: Combination of ACE inhibitors with other drugs such as beta-blockers (e.g. carvedilol, metoprolol, and propranolol) or dehydrating agents (including bumetanide, furosemide, hydrochlorothiazide piretanide, spironolactone, and triamterene). In addition, cardiac glycosides are used to strengthen the heart (e.g. beta-acetyldigoxin, digoxin and digitoxin or metildigoxin).
    • Nitro-based vasodilators (such as glycerol trinitrate, isosorbide mononitrate, isosorbide dinitrate, or molsidomine) can improve the blood and oxygen supply to the heart. They also relieve the heart’s pumping function. The active ingredient chlortalidone from the group of thiazide diuretics has antihypertensive and dehydrating effects.

Operative Therapy

Surgery may also be an option to treat heart failure. This can be, for example, the implantation of a pacemaker or a defibrillator (cardiac shock). In very severe cases, a heart transplant must be considered. However, the doctor decides on the need for these therapeutic measures on an individual basis.

Therapy Of Incipient Cardiac Insufficiency

The doctor will recommend a healthy lifestyle and physical activity for the treatment of emerging or mild heart failure. He will advise overweight people to lose weight. Smokers should quit the vice. Furthermore, alcohol consumption must be reduced to a minimum. In the Special Heart-Healthy Living you will find a multitude of suggestions with which you can keep your heart healthy or support the treatment of heart failure in a meaningful way.

Self-Help Against Heart Failure

You can improve symptoms of mild heart failure by adopting a healthy lifestyle with plenty of exercises. Regular physical activity has a strengthening effect on the heart. Before cardiac patients do exercise, however, they should ask a doctor for advice. Special cardiac sports groups (or coronary sports groups) are particularly recommended. Your health insurance company will be happy to inform you about offers in your area.

Self-Medication For Heart Failure

Self-medication in the case of heart failure with over-the-counter medication may only take place after a medical consultation. If you have a doctor’s permission, there are two groups of active ingredients that you can use for heart failure:

  • heart-strengthening herbal ingredients made from hawthorn, adonis herb, lily of the valley herb, sea onion, and oleander leaves
  • Circulatory stimulants such as moxaverine and plant ingredients from camphor, real daphne, and rosemary.

Prevention

    • Reduce excess weight and eat a fresh and balanced diet.
    • Eat a diet with an as little salt as possible (less than 3 grams per day).
    • Avoid excessive alcohol consumption.
    • Quit smoking.

Eat And Drink Properly Before Sleep

You disturb your sleep with a heavy meal in the evening. Easily digestible food belongs on the table in the evening. With our tips for the right food and drink in the evening, you will make falling asleep and staying asleep easier. Digestive sleep after a large meal is a widespread habit in many cultures.

Eating actually makes you tired – because the body needs energy for digestion. This energy is then not available for activity. But as beneficial as digestive sleep maybe, an afternoon nap can aggravate sleep problems. And even if lavish food makes you tired, it disturbs your night’s sleep. This also applies to stimulating drinks with caffeine or alcohol. If you want to sleep well, you should eat and drink the right thing in the afternoon at the latest.

No Caffeine After 4 p.m.

If you have problems falling asleep, you should avoid stimulating drinks such as coffee and cola or energy drinks relatively early in the day. Caffeine and guarana, which are contained in many energy drinks, only break down very slowly in the body. You should therefore refrain from drinking such drinks at least 4 hours before going to bed. By the way: black tea and green tea also contain caffeine.

Alcohol Disrupts Night Sleep

One of the common misconceptions about healthy sleep is that alcohol promotes sleep. Admittedly, many people fall asleep better if, for example, they drink a beer or a glass of red wine in the evening. Nevertheless, the breakdown of alcohol disturbs the nightly recovery processes, influences the flow of sleep phases, and promotes sleep disorders. Getting in the mood for the night with herbal teas Teas made from herbs or medicinal plants are particularly good drinks in the evening. Whether chamomile, fennel, hops, valerian, or other plants and plant mixtures: You have a large selection in which there is something for almost everyone.

Eat And Drink Properly Before Sleep

Don’t Eat Hard In The Evening

In order not to burden your sleep unnecessarily, you should preferably eat lightly in the evening. The simple rule of thumb applies the later, the easier. There should be about 2 to 3 hours between going to bed and your last meal. If you go further apart, you could get hungry again – and this disturbs sleep as well as overeating.

Easily Digestible Food Promotes Sleep

Lean meat, low-fat milk, and spices that are not too hot are recommended for a light dinner. You should avoid flatulent foods such as fresh wholemeal bread or legumes in the evening. White bread, pasta, potatoes or fruit are more suitable. Instead of fried French fries and pork schnitzel, you prefer turkey breast and low-fat dairy products for better sleep. Dairy products contain sleep-promoting tryptophan, as do dates and fish. Vitamin B 6 also promotes sleep. This vitamin is found in bananas and many leaf salads, among other things.

The Bedtime Treat

From the point of view of sleep researchers and doctors, a little sweet in the evening is allowed – sometimes even desired. A bar of chocolate, a cup of warm cocoa, a few cookies, or a small portion of sweet fruit influence the blood sugar level in such a way that it is easier for us to fall asleep. In addition, sweet things have a calming effect in small doses – without any risk of addiction and without disturbing the sleep process, as is the case with alcohol.

Use Sleeping Pills Properly

Taking sleeping pills is sometimes unavoidable – and a gift of blessing. But after a short time, they cause addiction. Read how to use sleeping pills correctly – so that sleeping pills don’t become the cause of sleep disorders. As paradoxical as it may sound, sleeping pills are one of the most common reasons for sleep disorders. Because almost all sleeping pills intervene deeply in the chemistry of sleep and are often also addictive. But sometimes sleeping pills are the drug of choice. However, it is important that you use sleeping pills properly.

Always Take Sleeping Pills For A Short Time

The most important guideline for the correct use of sleeping pills: Always take sleeping pills for as short a time as possible. You should never use sleeping pills for more than a week without medical advice. Depending on the type of medication, for example, prescription sleeping pills such as benzodiazepines can quickly develop into addiction. But over-the-counter sleeping pills can also be addictive. If your doctor keeps issuing sleep medication prescriptions without asking, it is best to contact another doctor to treat any sleep disorders.

Sleep Pills And Addiction

According to the German Central Office for Addiction Risks, around half of the users of sleeping pills develop an addiction to sleeping pills. In Germany alone, that is 400,000 sleep pill addicts every year. In total, around 2 million people are considered dependent on sleeping pills. About half of these people use the commonly prescribed benzodiazepines. Women are particularly susceptible to drug addiction and sleeping pill abuse. Numerous studies suggest that sleeping pills can significantly reduce life expectancy.

Use Sleeping Pills Properly

Sleep Pills Only If Verifiably Necessary

Sleep pills, and especially chemical sleep pills, are only suitable for self-treatment within very narrow limits. If, for example, you cannot sleep for understandable reasons such as jet lag or after an emotionally moving or stressful experience, a sleeping pill can be a blessing. Using sleeping pills to help you sleep despite your nervousness before an exam, on the other hand, is not a good idea. Almost all sleeping pills can work well into the day and severely limit physical and mental performance.

Big Market For Sleeping Pills

Despite the narrow limits of self-treatment, the market for over-the-counter sleeping pills and tranquilizers has been growing for years – even against the general trend. In 2012, Germans spent almost 200 million euros on non-prescription drugs for restlessness and sleep problems. Around 20 million packs of prescription benzodiazepines and similar substances went over the pharmacy counters (estimated turnover: 300 million euros).

Always See a Doctor If You Have Trouble Sleeping

If you have persistent sleep disorders, you should always contact an expert. This can be your family doctor or a psychologist. The sooner a sleep disorder is recognized, the more effective the treatment will be. Fortunately, most sleep disorders can be treated well. For otherwise healthy people, sleep specialists usually use non-drug methods such as sleep restriction and other behavioral therapeutic measures such as sleep rituals and a regular sleep rhythm.

Pregnancy Test: Hormonal Evidence of Pregnancy

After a fertilized egg has implanted in the uterus, the concentration of the hormone HCG (human chorionic gonadotropin) in the blood and urine increases sharply. A pregnancy test can measure this increased concentration of HCG in the urine. Modern pregnancy tests can indicate pregnancy immediately after the absence of the period or even 10 days after sexual intercourse.

Pregnancy Test

The procedure is slightly different for the individual tests. The concentration of HCG hormones is highest in the morning urine immediately after getting up, but most tests can be carried out at any time of the day. In modern tests, a test stick or test disc is simply moistened with urine and after a short time, the result can be read. The test consists of a control field, which changes color to indicate whether the test was carried out correctly, and a result field, which changes color only if you are pregnant. Slight discoloration in the right place in the results field also indicates pregnancy. However, the test should then be repeated after a few days. Even if the test was negative but there is no menstrual period, the test should be repeated.

Young preganant woman expecting a baby happy parent

When To See A Doctor

When the pregnancy test is positive. If the test is negative but there is no bleeding. What your doctor can do:

    • The doctor can detect HCG hormone in the blood during pregnancy.
    • The doctor can use ultrasound to determine whether you are pregnant.

Workout Against Tension

Tension Trap At The Desk

Among classic “desk criminals” who do their work every day in front of the computer in the office, it is rather the exception that they have never had neck, shoulder or back tension. These annoying tensions haunt most of those affected for years and, if ignored, can lead to hardening and restricted mobility in the long term.

Exercise and the correct sitting position are good ways out of this tension trap. But just sport is not the solution here either, because those affected should make sure that the problem areas are also mobilized. Exercise generally relaxes the muscles, but jogging, for example, is not suitable for specifically targeting neck or shoulder tension. An effective means of counteracting this is mobilizing the affected areas. In the following, therefore, exercises are presented on the one hand that comfortably and quickly loosen and stretch the areas. There are also helpful tips on how to achieve a good sitting position in front of the screen.

    1. Relaxation of the neck

The starting point for this exercise is an upright, sitting position. Hold on to the chair seat with both hands. Then slowly tilt your head to the left so that the ear moves towards your left shoulder and hold this position for 3 breaths. Gently pull your right shoulder downwards.

Then change sides. Repeat the exercise 3 times.

More exercises:

    • Bring both arms forward. Pull your shoulders forward as well.
    • Then cross your arms behind your head. The neck remains long. Slowly push your head against the resistance of your hands.
    1. Relief Of The Shoulder Girdle And Thoracic Spine

The starting point for this exercise is an upright, sitting position. Let your arms hang down and relax your hands on your thighs:

Then first lift one shoulder up to your ear while you breathe in. Now let your shoulder fall and breathe out.

Then do the exercise with the other shoulder. The third time, use both shoulders at the same time, inhaling again as you lift and exhale as you lower your shoulders. Repeat the exercise 3 times if possible.

Another exercise:

    • Your arms hang relaxed next to your thighs. Now drop your shoulders forward, twisting your thumbs inward and exhaling. Then pull your shoulders back and straighten your body, twisting your thumbs outward and exhaling again. Finally, let your shoulders fall forward, turning your thumbs inward again and exhaling again. Also repeat this exercise 3 times if possible.

Workout Against Tension

    1. Relief of the lumbar spine

Please sit on the front edge of the chair. The hands lie loosely on the thighs. Now please make your back as round as possible and breathe out. Then make a slight hollow back and breathe in. Please repeat this exercise 5 times.

More exercises:

    • Please sit back on the front edge of the chair. The arms hang loosely to the side. Now lift your right foot – hold it for a breath – and then lower it. Then repeat this with your left foot. Repeat this exercise several times (up to 30 times), paying attention to maintaining the upright sitting position.
    • Extend your arms sideways to the floor, palms facing forward. Pull your shoulders back and tense your stomach and buttocks. Hold this tension for 3 breaths. Then let go again. Repeat this exercise 4 times.
    1. Relaxation For Your Face

To relax the face, you must first contract the following muscles and hold them for about 2 breaths. Then release the tension by exhaling and relax for about 5 breaths at a time.

    • Raise the eyebrows.
    • Screw up your eyes.
    • Press your lips together.
    • Make your mouth really wide, like a clown.
    1. Relaxation of the eyes

Rub your palms against each other quickly and vigorously to warm them up.

Now place your palms over your closed eyes so that no light can penetrate. No pressure should be applied.

Please make sure that you do not tense the neck and back muscles. Breathe calmly and evenly. Relax your eyes and enjoy the soothing warm darkness. After 2-3 minutes, take a few deep breaths and take your hands away from your eyes. The light will then blind you for a short time.

Another exercise:

    • Keep your eyes moving. Wander around the screen every now and then and feel the surroundings with your eyes. Try to concentrate on things at the edge of your field of vision, this strengthens your perception.
    1. Exercises To Relax Arms And Hands

The arms are extended in front of the body at shoulder height, with the palms facing down. Now make a fist and bring the fist to your chest. the elbow stays at shoulder height. The arms are then brought forward again in one quick movement. Repeat this exercise 5-10 times.

Extend your arms forward, palms facing the floor, and hold this position. Now bend your wrist so that the palms point towards your body. Then fold your hands up so that the back of your hand is facing your body. Keep your fingers stretched during this exercise. Repeat this exercise 6 times.

More exercises:

    • Extend your arms forward long. Spread your fingers wide apart. Now make a fist. Then spread your fingers wide apart again. Please repeat several times.
    • Frequently let your arms hang down relaxed and then shake out your arms, hands and fingers vigorously for 5 seconds.

Glycemic Index Used To Measure Blood Sugar Levels

In one case, a high-carbohydrate diet can be just the right way to get overweight under control. Others seem to be exactly the opposite. Scientific studies underline this statement: the less fat and the more carbohydrates people ingest, the fatter and sicker they get! The reasons for this are complex: There are carbohydrates that get very quickly from the intestines into the bloodstream and cause a rise in blood sugar levels.

Influence Of Carbohydrates On Insulin Levels

Insulin – a hormone from the pancreas – now has to regulate the blood sugar level back into the normal range. If the blood sugar level rises sharply, there is an enormous activation of insulin and, as a result, a drop in blood sugar below the norm. This hypoglycemia manifests itself as tiredness and an increased appetite for sweet foods. If you give in to cravings and eat foods rich in carbohydrates, the blood sugar can again rise above the norm and cause further insulin activation. Accordingly, hypoglycemia and hypoglycemia alternate regularly with a corresponding release of insulin.

This is where the problem begins: a high-carbohydrate diet can be a cause of increased insulin levels. As medical research has shown, an excess of insulin means that the organism does not burn fats that it ingests with food, but instead increasingly stores it as fat reserves, while at the same time reducing fat loss. In short: high insulin levels can lead to weight gain. However, the influence of carbohydrate foods on this process varies. Some have the ability to raise blood sugar levels more than others.

Glycemic Index Used To Measure Blood Sugar Levels

The so-called glycemic index (GI) is used to assess which carbohydrates are “good” and which are “bad”. The GI is a measurement that tells you how much your blood sugar level rises after consuming a certain food. A low GI is below 40, a medium is 40-70 and a high one is above 80. The selection of carbohydrate sources with low and medium GI is advantageous, as these cause only slight fluctuations in blood sugar and insulin and thus disinhibit fat burning.

Glycemic Index

The Glycemic Index is a practical tool for diet planning for weight loss, but it should not be overstated. Studies show that there are strong intra- and inter-individual differences in the GI. Intra-individual differences mean that one and the same person can have different blood sugar levels depending on the time of day and previous physical activity. Early in the morning, there is typically a lower increase in blood sugar levels and thus insulin than in the evening, as the cells’ insulin sensitivity decreases over the course of the day. Exercise also leads to a lower increase in the level of glucose in the blood. This means that there can be differences of up to 30% in the GI for the same person and the same food.

It should also be borne in mind that when determining the glycemic index, the food was eaten in isolation and contained exactly 50 g of carbohydrates, which does not correspond to natural eating habits at all. Rather, our food consists of a combination of different foods, which can have a strong influence on the course of the blood sugar level. Combining carbohydrates with fat, protein, and/or fiber results in a slower or faster rise in blood glucose than with isolated administration.

In addition, there are foods with a relatively high GI, but due to their low carbohydrate content, they do not trigger any significant fluctuations in blood sugar. For example, to take in 50 g of carbohydrates by eating carrots with a high GI of 71, one would have to consume around 850 g of carrots. The actual effect on the blood sugar level and thus on the insulin release is correspondingly small with a normal portion of 100-150 g.

With regard to the insulin response, the glycemic index alone is of little informative value, since the insulin response is dependent on both the type and the number of carbohydrates supplied and is also influenced by other nutrients. In order to take this into account, the term “Glycemic Load” (GL) has recently been used, translated as glycemic load or glycemic load. The GL is calculated by dividing the glycemic index by 100 and multiplying the result by the number of carbohydrates consumed. Accordingly, z. B. with 5.3 the value for the glycemic load of 100 g carrots. Large portions of pasta, rice, potatoes, and pastries have a high glycemic load. Scientific studies show an increased risk of developing diabetes and cardiovascular disorders in a diet with high GL.

Typical Symptoms Of Sore Throat

Symptoms

The reddened lining of the throat, scratching and pain in the throat, difficulty swallowing, and fever are the typical symptoms of sore throat. Often, as a sign of an alarming immune system, the lymph nodes in the lower jaw and neck are swollen. In the case of tonsillitis (the technical term is angina tonsillaris or tonsillitis), there are also swollen and reddened or even ulcerated tonsils. If the larynx or vocal cords are inflamed, there is also hoarseness.

A scratchy, swollen throat is often associated with a cold or flu. In many cases, there are also annoying swallowing difficulties and hoarseness. You can find out more about the causes and treatment of sore throats here.

It often begins with a scratchy throat or difficulty swallowing: sore throats announce themselves. Most often, a sore throat is a symptom of a cold, flu, or other respiratory infection. Typically, a sore throat will go away with the underlying viral infection. Antibiotics help if the cause of infection is bacterial, such as tonsillitis.

Causes

A sore throat can be a symptom of an isolated infection caused by a virus or bacteria. Most often, a sore throat is a symptom of a cold, flu, or other respiratory infection. The germs cause inflammation of the mucous membrane in the throat area. Depending on where the pathogens settle, a distinction is made between inflammation of the lining of the throat (pharyngitis), inflammation of the vocal cords or larynx (laryngitis), or tonsillitis or angina tonsillaris. Mixed forms also occur.

In addition to bacteria and viruses, sore throats can also be caused by overuse of the voice and irritation of the airways (for example from chemicals, tobacco smoke, or dust). Other diseases such as mumps, scarlet fever, or Pfeifferscher’s glandular fever also cause sore throats.

Sore throats also occur due to esophageal or stomach disorders. The backflow of stomach contents through the esophagus causes heartburn, which is often accompanied by a sore throat.

Sore Throat

Causes Of A Sore Throat At A Glance

    • Cold, flu, angina (tonsillitis)
    • Overuse of the voice by singing, shouting, talking for a long time
    • Irritation of the respiratory tract from chemicals, smoke, or dusty, dry air
    • other diseases, e.g. glandular fever, pseudocroup, mumps, scarlet fever
    • Heartburn from gastric acid reflux
    • very rarely malignant tumors in the throat area.

Treatment

Sore throats usually do not require medical attention. Exceptions: The symptoms are very severe, do not subside after a few days, there are breathing difficulties or there is a suspicion of tonsillitis or other diseases.

Treatment Of A Sore Throat At The Doctor

If a bacterial infection is causing a sore throat, your doctor will prescribe antibiotics to fight the bacteria that cause disease. Antibiotics do not help with viral infections. Here the symptoms can be alleviated with home remedies and over-the-counter medicines.

Home Remedies For A Sore Throat

The following home remedies have proven to be particularly effective for helping yourself with a sore throat.

    • drink a lot
    • keep warm, especially your throat and chest, but do not sweat
    • keep the room air moist in winter
    • Avoid irritants, do not smoke
    • Gargling or inhaling herbal ingredients from arnica, Icelandic moss, chamomile flowers, thyme, linden flowers or sage leaves.

Over-The-Counter Drugs For A Sore Throat

    • Disinfecting gargle solutions, mouth sprays, or lozenges with active ingredients such as hexetidine or cetylpyridinium chloride have anti-inflammatory effects.
    • In the case of slight reddening and pain, anti-inflammatory lozenges or rinsing solutions (e.g. chamomile or sage extracts for rinsing, tablets containing dexpanthenol for sucking) are effective.
    • Lozenges or sprays with superficial anesthetics help with pain and difficulty swallowing.
    • In the case of more severe pain, short-term anti-inflammatory pain pills for ingestion with acetylsalicylic acid, ibuprofen or paracetamol, which at the same time reduce fever, are useful.
    • The local application of antibiotics usually does not make sense.

Prevention

It is only possible to a limited extent to prevent a sore throat. Basically, the same recommendations apply that you can read under respiratory infections and colds.

Homeopathy

Homeopathy is viewed as a stimulus therapy in which the body is given incentives to heal a disease on its own by taking certain, highly diluted remedies. The term “homeopathy” is made up of the Greek words “homoios” (similar) and “pathos” (suffering). In homeopathy, the disease is mainly treated by means that work according to the so-called similarity principle. It is based on the observation that a substance that causes certain complaints in humans or animals can also cure the same (or similar) complaints. Within homeopathic teaching, there are different directions with different conceptions of how the homeopathic principles should be implemented.

Origin And Philosophy Of Homeopathy

The principle of similarity occurs in different cultures and also in the writings of the ancient Greeks, for example with Hippocrates. The similarity principle was also taken up, again and again, later in the course of medical history. The German doctor, pharmacist, and chemist Dr. Med. Habil. However, Samuel Hahnemann (1755 – 1843) was the first to systematize this principle and use it as the basis for a new direction in medicine. His “Organon” and other publications are still used in practice by homeopaths today.

Hahnemann developed homeopathy on the basis of a large number of self-experiments with medicinal products. His first self-experiment took place with cinchona bark, which was used to treat intermittent fever (malaria). Hahnemann took a large amount of cinchona bark without having a fever himself and developed a fever. After several further attempts with different drugs, he came to the conclusion that substances that cause certain symptoms (e.g. fever) in healthy people can cure the same symptoms (e.g. febrile colds) in sick people. According to Hahnemann, the organism of a sick person receives an impulse from the drug to use its defenses in a targeted manner against certain symptoms of the disease.

The principle of homeopathy is based on these findings: «Similia similibus curentur» (the like is cured by the like). Hahnemann discovered in further theoretical and practical investigations with medicinal products that the effectiveness of the substances changes due to their concentration. Diluted drugs often showed a stronger effect than the undiluted basic substance. Thereupon he developed a special production and dosage theory, the potentization process and the principle of the smallest dose.

Manufacture Of Homeopathic Remedies

When producing homeopathic remedies, one proceeds according to a homeopathic drug book. The starting substance is gradually diluted in a certain ratio with water, alcohol or lactose and potentized after each dilution step by shaking or rubbing. Today, three different dilution series are used in homeopathy: D, C, and LM. The only difference between the D and C series is the dilution ratio:

D = decimal power

Dilution ratio: 1: 9 (Latin decem = 10)

In the D series, one part of Vorpotenz (for example D1) is mixed with nine parts of thinner and then shaken vigorously at least ten times (liquids) or rubbed in a mortar for an hour (powder). The result is a D2, which you dilute again tenfold and potentiate to produce the D3.

C = centesimal power

Dilution ratio: 1:99 (Latin centum = 100)

In the C series, one part of pre-potency (for example C1) is mixed with ninety-nine parts of diluent and then potentized.

LM or Q power:

Each dilution step corresponds to a ratio between starting substance and diluent of 1: 50,000.

Hahnemann developed the third series of potentiations, called LM or Q potency, in the last years of his life. LM potencies are produced using a special, very complex process. Each dilution step corresponds to a ratio between the starting substance and the diluent of 1: 50,000. The higher the number after the D, C or LM, the stronger and longer-lasting the effect of the homeopathic medicine.

Powers above D30 or C30 are called high potencies. These are mainly used by homeopaths to treat chronic ailments.

Homeopathy

Application Of Homeopathy

Homeopathic remedies are mainly supplied in the form of globules, drops, tablets, and ointments. Some doctors also give homeopathic medicines through a syringe. Before a new homeopathic drug is used to treat sick people, it is only tried on healthy test subjects (drug testing on healthy people). These write down the physical and psychological changes that occur after taking the product. These changes indicate which symptoms in sick people could be alleviated with the same remedy. For example, homeopathically diluted bee venom (apis) is used to relieve symptoms caused by a bee sting, provided that it is a pink swelling that is warm to the touch and the pain is relieved by applying ice. Another simple example is remedies made from homeopathically diluted onion extracts. These are given off in the case of a cold, in which the eyes water and the nose runny.

In the case of complex diseases, the homeopath needs a lot of experience to find the right remedy. The active ingredients used in homeopathy mainly consist of natural substances such as plants, minerals, and animal substances. “Classically”, that is, according to Hahnemann’s teaching, working homeopaths administer so-called “individual remedies” to their patients. Individual remedies consist of a single basic substance, for example, a mineral, an animal substance, or an extract from a flower, and they contain a whole range of ingredients from the plant.

The homeopath recognizes that he has chosen the right remedy for the treatment of his patient, among other things by the so-called «initial worsening» (healing reaction) of the symptoms. This means that the patient’s illness may worsen in the initial phase of treatment. Such initial aggravations are usually more severe, the higher the potency of the administered agent, i.e. the greater the dilution. After the initial deterioration has disappeared, a significant improvement in the state of health can occur within a few days. Mixed preparations made from various individual remedies are mainly used in the treatment of acute illnesses such as flu, runny nose, or indigestion. They are very suitable for self-medication. However, many classic homeopaths reject the administration of mixed preparations.

So that the homeopathic remedies develop their optimal effectiveness, one should observe certain rules when taking them, for example, Homeopathic remedies should be taken as often as necessary and as rarely as possible. The more acute and serious disease is, the more often you should take the remedy. If the symptoms of the disease improve significantly, the homeopathic remedy should no longer be taken. If possible, you should not combine several homeopathic remedies. In the event of a healing reaction, the drug should be discontinued until the reaction has completely disappeared.

Homeopathic Technique

Before each homeopathic treatment, the individual clinical picture must be precisely recorded in a detailed and long conversation. In the initial consultation, the patient describes his symptoms as detailed as possible so that the homeopath can draw conclusions about appropriate homeopathic remedies from the clinical picture. In the case of headaches, for example, a distinction is made between whether the pain is felt as throbbing, pulling, or stabbing, whether the pain tends to subside in the fresh air or in closed rooms, or whether the patient feels the need to lie down to relieve the symptoms. The homeopath chooses a suitable remedy depending on the pain sensation. Further information about the patient will help him with this. He, therefore, asks about the patient’s inclinations, interests, character, and reactions to environmental stimuli. He also takes physical characteristics such as height, weight, and constitution into account when making his assessment.

After the initial consultation, the homeopath looks up the important symptoms in a so-called “repertory”. This look-up is therefore called “repertorisation”. Depending on the nature of the complaints, the repertorization places more emphasis on the physical complaints or on the personality of the patient. In classical homeopathy, the same remedies are not administered to every patient with the same symptoms. Depending on the type of person affected, the treatment is adapted accordingly. For this reason, the first interview plays a crucial role. In contrast to chronic complaints, it is usually much easier to find the right remedy for acute illnesses. The dispensing of homeopathic remedies without considering accompanying symptoms as well as alleviating or worsening influences is not considered a correct homeopathic treatment in the circles of classic homeopaths practicing according to Hahnemann.

Effect Of Homeopathic Remedies

Hahnemann explained the effectiveness of homeopathic remedies by stating that it is not the concentration that is decisive, but the “dynamization” or the release of a force of the substances. This happens during potentization: By shaking the substance several times, the information on the basic substances should be transferred to the diluent, even if no basic substances can be detected materially or chemically. The effect of the diluted basic substances should enable the body to heal its illness with its own strength. In the meantime, many doctors trained in conventional medicine also use homeopathy to treat various diseases, for example:

    • Allergies (but not in the case of life-threatening reactions)
    • Defensive weakness
    • Chronic diseases
    • Psychosomatic illnesses

Side Effects Of Homeopathic Preparations

Today there are around 2500 homeopathic single and mixed preparations available, which are used for many diseases. However, a necessary surgical intervention or the supply of vital substances cannot be replaced by homeopathic therapy. That is why homeopathic remedies are only used as an accompanying therapy in the treatment of serious, acute illnesses.

Epigastric Hernia

Doctors call an epigastric hernia a break in the upper abdominal wall between the navel and the lower end of the sternum. When fat and connective tissue penetrate from the abdominal cavity through the layers of the abdominal wall and a sack-like protuberance of the peritoneum forms a so-called hernial sac, this is a hernia. Epigastric means: relating to the upper abdomen (the epigastrium).

Frequency

Epigastric hernias are comparatively rare. They only make up 5 percent of all hernias. Inguinal hernias (inguinal hernias) or umbilical hernias (umbilical hernias) are much more common.

Symptoms

In many cases, epigastric hernias go unnoticed because the fractures are either very weak or hardly any tissue from the abdominal cavity slides into the hernial sac.

When abdominal wall fractures cause discomfort, the fat and connective tissue of the large network, the so-called greater omentum, has often shifted. In rare cases, parts of the small intestine also enter the chest through an epigastric hernia. In these cases, severe upper abdominal discomfort usually occurs, which increases with pressure.

Epigastric Hernia

This pressure is usually built up from the inside, for example by carrying heavy loads. Persistent sneezing (for example with allergies), persistent coughing (for example with chronic lung diseases such as COPD) or strong pressure during bowel movements (especially with constipation) increase the pressure in the upper abdomen.

The bulging hernial sac is usually visible and palpable from the outside. In rare cases, acute epigastric hernias are accompanied by nausea, fever, or vomiting.

Complications

Complications arise when the tissue in the hernial sac of an epigastric hernia becomes twisted and disconnected from the blood supply. This is a medical emergency that requires immediate surgical treatment. If the trapped tissue dies, there is a risk of life-threatening infections of the chest or abdominal cavities such as peritonitis or pneumonia.

Treatment

Small abdominal wall hernias without symptoms do not necessarily have to be operated on. A symptomatic epigastric hernia is usually treated surgically (fracture closure), as the risk of abdominal organs slipping into the chest increases over time. If the abdominal wall needs stabilization, a plastic mesh can be implanted, for example, which reliably closes the abdominal wall hernia.

Pulmonary Emphysema

Pulmonary emphysema is primarily the end-stage of lung diseases such as chronic bronchitis or COPD. Read more about symptoms, causes, and treatment.

Synonyms

Emphysema pulmonum, pulmonary emphysema, pulmonary hyperinflation, pulmonary distension

Definition

Pulmonary emphysema is a serious, progressive, and incurable disease of the lungs. Medical professionals also refer to it as pulmonary emphysema. The colloquial language is particularly familiar with the disease terms lung flatulence or lung overinflation. With pulmonary emphysema, lung function continues to decrease. This creates progressive shortness of breath. The associated lack of oxygen not only severely restricts physical performance. There are also secondary reactions that place a heavy strain on the heart, among other things. A typical consequence of emphysema is, for example, the cor pulmonale, a common form of right heart failure.

Alpha-1 Antitrypsin Deficiency

In addition to the acquired form of emphysema, there is also a congenital variant. Alpha-1-antitrypsin deficiency is one of the rare diseases with 2.5 new cases per 10,000 inhabitants per year. In this disease, the congenital deficiency of the protein alpha-1-antitrypsin triggers chronic inflammatory processes in the lungs.

Frequency

According to experts, the frequency of emphysema is growing worryingly. Exact figures are not available because emphysema and COPD are not always properly recorded separately. But it is assumed that there are around a million cases in Germany. The vast majority of emphysema occurs in smokers over the age of 50.

Symptoms

A characteristic symptom of emphysema is increasing shortness of breath (dyspnoea). As a rule, the shortness of breath initially only occurs during physical exertion. As the disease progresses, there is difficulty breathing even when the body is at rest.

Advanced emphysema causes chronic oxygen deficiency, which can be recognized by the blue color of the lips and fingers (cyanosis). Another visible symptom of emphysema is a barrel-like enlargement of the upper body, the so-called barrel chest. Doctors speak of the barrel chest. The barrel breast is created because the lung tissue continues to inflate.

Causes

By far the most common cause of emphysema is chronic lung diseases such as chronic bronchitis. If the bronchial passages are permanently inflamed, narrowed, and cause shortness of breath, coughing, and increased sputum, this chronic bronchitis is one of the chronic obstructive pulmonary diseases that are described in more detail under COPD. Chronic bronchitis and COPD are also precursors of lung cancer. The most common cause of all these diseases smoking.

Pulmonary Emphysema

How Do The Symptoms Of Chronic Bronchitis Arise

In healthy people, the air you breathe reaches the alveoli via the bronchi. Gas exchange takes place in these alveoli. During the gas exchange, the elastic alveoli absorb the oxygen from the inhaled air and then release carbon dioxide from the blood with the exhaled air. That requires a certain elasticity. In the case of emphysema, this elasticity is gradually lost as a result of inflammatory processes. The alveoli become increasingly inelastic and are no longer able to completely release the exhaled air. As a result, less fresh inhaled air can be taken in. This causes the alveoli to expand and ultimately lose their function entirely. Sometimes the small alveoli transform into large emphysema bubbles.

The approximately 300 million alveoli of a healthy person have a surface area the size of a football field. With emphysema of the lungs, this area for gas exchange sometimes shrinks to the size of a towel.

Treatment

Pulmonary emphysema cannot be cured. Treatment can only relieve symptoms. The most important thing is to prevent the disease from progressing, or at least to slow it down. To do this, it is imperative to stop smoking.

Drug Therapy For Emphysema

The symptoms of not too advanced pulmonary emphysema can be alleviated by drug therapy. The aim of this therapy is to widen the bronchi (bronchodilation) and to stop the inflammatory processes in the lungs. So-called beta-2 sympathomimetics are often inhaled for this purpose. Active substances in this group are salbutamol, salmeterol, or reproterol. Anticholinergics like ipratropium or inhaled glucocorticoids like budesonide, beclometasone, or fluticasone have even stronger anti-inflammatory properties.

In the case of congenital alpha-1-antitrypsin deficiency, the protein can be given in the form of medication (infusions) and thus prevent the development of pulmonary emphysema. Unfortunately, the therapy is very costly and not as promising as one initially hoped it would be.

In the case of very advanced pulmonary emphysema, selected emphysema patients (younger than 60 years, high therapeutic motivation, no additional complications) only have a lung transplant as the last chance. The possibilities of artificial ventilation are very limited due to the characteristics of the disease.