ways to get rid of headache

ways to get rid of headache

ways to get rid of headache

Headache is the common symptoms experienced by more than 50% people worldwide.

Headache is one of the problems that give headache to the treating physician because of the multiple types and multiple causes.

What is a Cause of headache?

Headache is the ache(pain) arising from structures and tissues around the brain and skull like eyes, sinuses, ear, muscles, blood vessels, nerves and spinal cord. Brain itself cannot feel pain.

Headache can also be a symptom of some other serious condition or disease.

Headache is three times more common in women than men.

What are the types of headache?

There are many varieties of headache and lots of subtypes.

The most common types of headache are Tension Headache, Migraine and Cluster Headache.

Tension Headache

Tension headache is usually bilateral (both sided) and it is not pulsatile. It is a dull ache felt all over the head.  Tenderness may be felt around the scalp muscle and neck. There is no associated nausea or vomiting. Scalp muscle tenderness may be present. Tension headache is often triggered by mental stress.

Stress relief, antidepressants, analgesics and gentle massage may help to reduce the pain.

Migraine

Migraine is a miserable form of headache normally affects one side of the head. Migraine is usually associated with nausea and vomiting. An aura (seeing flash of light, blind spots, stars or zig zac lines ) may precede the ache. Migraine can occur without aura also. Migraine headache may be throbbing and may be worsened by routine activities

Migraine is due to disturbance in the brains vascular tree. Dilatation of blood vessels produces pain due to stretching of the arterial wall. Migraine may be triggered by flashing light, anxiety, stress, exercise, menstruation, oral contraceptives, chocolate, artificial sweetener, mono sodium glutamate (agino moto) and alcoholic drinks.

Cluster Headache

Cluster headache is the most disabling type of headache. It is characterized by sudden onset of excruciating pain around or behind one eye. The eye may become bloodshot, watery and lacrimating and may have eye lid swelling.  Cluster headache usually starts at night and lasts for few minutes to hours. One headache will resolve and another will follow. It comes in cluster for few weeks followed by headache free period of months. Cluster headache is more common in men than women.

Other Types of headache

Sudden single attacks

Patients can have acute headache for short period in conditions like head injury, fevers, sinusitis, meningitis, encephalitis, bleeding in side skull like subarachnoid haemorrhage, sudden increase or decrease in blood pressure and over straining can also produce headache.

Increased intra cranial pressure, tumors of brain, decreased CSF pressure after lumbar puncture or spinal anesthesia can also produce headache.

Referred headache

Infections of eye, glaucoma, refraction errors and over strain to eyes may give headache.

Dental conditions, diseases of the nose and sinuses, diseases of ear and cervical spondylosis can also produce headache.

Headache due to condition in nerves

Conditions in cranial nerves can produce headache like Trigeminal neuralgia, Glossopharyngeal neuralgia and Temporomandibular neuralgia can produce headache.

Psychogenic headache

Conditions like anxiety, depression, schizophrenia and hysteria can produce headache. They are of pressing type, continuous and severe. The headache are not relieved by analgesics.

Vascular headache

Throbbing headache increases on movement of the head.

Hypnic headache

Usually affects elderly people at night and wake them up during sleep.

Hangover Headache

Drinking too much alcohol at night may produce throbbing headache next morning. Drinking lots of juices and eating sugary food to reduce the headache.

Rebound Headache

Taking too many medicines regularly for headache, becoming dependent on the medicines and suddenly stopping the drugs may produce rebound headache.

Caffeine Headache

Drinking lots of coffee daily and withdrawing  coffee suddenly cal alter the brain chemistry and trigger headache.

Ice cream Headache

Drinking Ice cold drinks or eating very cold ice cream can stimulate the nerve ends in soft palate and produce headache.

Hormonal Headache

Pregnancy, menstruation or taking birth control pills can alter the hormone levels and produce headache.

Investigations for Headaches

Detailed history of the Headache, the type of headache and associated symptoms will give a clear idea about the investigations to be done.

X-rays of skull, Para nasal sinuses and cervical spine will give evidence regarding the headache.

CT scan or MRI scan of brain may be necessary to rule out intracranial causes.

Ophthalmic, ENT (Ear, nose and throat), and dental examinations will rule out referred pain from these organs.

Psychiatric assessment is also necessary.

How do you get rid of headache?

It is better to consult your physician than taking over the counter medications.

Rest, gentile massage, breathing exercises, warm or cold compress and stress busters will relive headache.

Medications like Aspirin, Ibuprofen, Aceclofenac and Paracetamol can be given to get rid of headache.

In migraine Triptans and Ergot alkaloids will relieve pain.  Flunarizine, propranolol or amitriptyline can prevent migraine attack.

Treat the cause in referred headache.

Prevention to get rid of headache

Removing triggers, avoiding stress, positive attitude, yoga and meditation will prevent headache.

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Gallstones – Types, Causes, Risks, Symptoms, Treatments

        Gallstones - Types, Causes, Risks, Symptoms, Treatments  Gallstones

 What is gallstone?

Gallstones are small stone like structures develop abnormally from the sediments (deposits) of bile (digestive fluid) in the gallbladder.

Gallstones are otherwise called as Cholelithiasis.

Gallbladder is a small pouch (bag) like organ found below the liver where bile is stored.

Causes of gallstones

When more bile is secreted by the liver or when the emptying of bile from the gallbladder is poor, the bile gets concentrated and become gallstone.

The common causes may be genetic, obesity (sudden increase or drastic loss of weight), using birth control pills, hormone replacement therapy, cholesterol medications, diabetes, pregency and eating lots of fried and processed foods. Hemolytic anemia and infection can also cause gallstones.

Gallstones are usually found in Fat, Fair, Fertile, Female of Forty with Family history of gallstones.(rule of F)

Types of gallstones

Cholesterol Stones

They are white, yellow or green in color and few in number. They may form up to 3 cm in size.

They are common and 80% of its contents are cholesterol.

Bilirubin Stones

Bilirubin Stones are darker and smaller in size and numerous in numbers. They are made up of mainly bile pigments and calcium.

Mixed Stones

They are made up of cholesterol, bile pigments and calcium.

Symptoms and Signs of gallstones

Normally Gallstones are painless. But pain starts when the stone enters the bile ducts and produce obstruction of bile flow.

Pain is usually felt in the upper portion of abdomen on the right side.( Right hypochondriac region). Pain may be felt just below the breastbone (Epigastria). Pain may also be referred to the right shoulder. Pain may be associated with nausea and vomiting. Stones in common bile duct can produce obstructive jaundice.

Murphy’s sign: When deep palpation is done just below liver (right upper abdomen below rib cage) and the patient in deep inspiration, the patient may feel severe tenderness. Pain is produced when the inflamed gallbladder come in contact with the hand.

Tests (investigations) done

As most of the gallstones are symptomless, they are diagnosed while doing investigations for other diseases.

X-ray chest

some gallstones are not visible on X-rays. Only radio-opaque stones are seen through x-rays.

Ultrasonogram (USG)

This is cheaper and noninvasive and investigation of choice for gallstones.

MRI (Magnetic Resonance Imaging)

MRI gives clear detailed images of the gallbladder, bile ducts and liver. It gives images of gallstones and dilatation of bile ducts.

MRCP (Magnetic Resonance Cholangiopancreatography)

Can visualize the biliary tree and gallstones.

ERCP (Endoscopic Retrograde Cholangiopancreatoscopy)

Here a flexible (Fibro optic ) endoscope is passed through the mouth, oesophagus and stomach to reach the duodenum. A dye is injected into the bile duct and scanning done and images are taken to visualize gallstones and biliary tree. Stones can be removed through ERCP.

PTC (Percutaneous Transhepatic Cholangiography)

Through a small incision in the skin of right upper abdomen and contrast material is passed into the biliary tree and images taken. Gallstones can be removed using PTC.

Blood Investigations

Blood tests like Liver function tests(LFT) and Pancreatic Amylase are done to rule out liver and pancreatic damage. Routine Blood tests are done to rule out other associated diseases.

Treatment for Gallstones

Most gallstones are painless, but when the pain is severe treatment is necessary.

Pain Killers: When the pain is severe, painkillers like antispasmodics, NSAIDS    ( non-steroidal anti-inflammatory drugs) or opiates can be given.

Antibiotics are given to prevent cholecystitis.

Cholecystectomy (surgical removal of gallstones and gallbladder) is the treatment of choice. This can be done through open surgery or through Laparoscope.

ERCP or PTC: Gallstones can also be removed through ERCP or PTC.

Lithotripsy: Here ultrasound shock waves are used to break gallstones into small fragments, which can be drained through bile duct into small intestine.

Medical Treatment: When the patient has severe comorbid diseases, medical treatment to dissolve gallstones were given.

Ursodeoxycholic acid can be given for a long period to dissolve cholesterol gallstones.