Diseases & Conditions Archive

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In the journals

It is often assumed that appendicitis means automatic surgery to relieve the pain and avoid complications. Yet, a study published online Sept. 25, 2018, by JAMA found that many people with uncomplicated acute appendicitis may be safely treated with antibiotics and avoid an appendectomy.

About 70% to 80% of acute appendicitis cases are uncomplicated, which means the appendix hasn't ruptured or formed an abscess. In the study, researchers had 530 people with uncomplicated acute appendicitis either undergo an appendectomy or receive 10 days of antibiotic therapy. After five years, 61% of the antibiotic group had no recurrences of appendicitis and no appendectomies.

Certain eye conditions offer clues to your chances of developing dementia.

It's long been said that the eyes are the windows to the soul, but can they also provide a view of your brain's future? Researchers increasingly say yes. Studies have identified links between common eye conditions and Alzheimer's disease and other forms of dementia.

One study, published in the July 2018 issue of Alzheimer's & Dementia, appeared to validate past findings that linked three eye diseases — glaucoma, age-related macular degeneration, and diabetic retinopathy — to an increased risk of Alzheimer's disease.

Ask the doctors

Q. I had a nosebleed the other night. I've heard that this can be more common in the winter. Is this true?

A. Yes, you could be more likely to get a nosebleed in the winter because the heated indoor air may dry out your nasal passages and make the tiny blood vessels inside them more fragile. Nosebleeds occur when these tiny vessels rupture. Sometimes the bleeding happens at the back of the nose, called a posterior bleed. Or it may develop at the front of the nose — an anterior bleed.

What can you do about this mysterious ailment?

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Leaky gut has not received the attention it deserves, in large part because it remains a medical mystery.

"Part of the reason is that the gut is such a complex system, and science continues to find new ways that the gut can influence everything from heart health to keeping our brains young," says Dr. Alessio Fasano, director of the Center for Celiac Research and Treatment with Harvard-affiliated Massachusetts General Hospital. "There is much we know about leaky gut in terms of how it affects people's health, but there is still so much that is unknown."

Ask the doctors

Q. I was recently diagnosed with hidradenitis suppurativa. What could have caused this condition, and can it be cured? What are the usual treatments?

A. Hidradenitis suppurativa is an uncommon skin condition that starts out as pimple-like lesions on the skin. If left untreated, it can grow deeper into the tissue and over time can lead to painful fluid-filled lumps or thick scars. The condition is most common on parts of the body where skin presses up against skin, such as the groin, the underarms, the thighs, or the buttocks. Hidradenitis suppurativa most often affects younger people, particularly women, and most often happens after puberty. It's less common in people over age 55. Other risk factors include smoking and being overweight or obese, and it seems to run in families. Experts aren't really sure what causes hidradenitis suppurativa, but hormones and the immune system may play a role. Some experts believe that an ordinary blockage in the skin triggers an overzealous immune system reaction, which leads to symptoms. The good news is that you can't spread the condition to other people, and it is treatable. Catching the problem early can minimize problems. There are numerous treatment options for hidradenitis suppurativa, including antibiotics, hormonal medications and skin treatments, such as acne washes or special bleach baths. In more severe cases, your doctor might also recommend biologic therapy to dampen the immune response or surgery to remove or drain the affected skin. Even after treatment, the condition may require ongoing monitoring to treat or prevent recurrences.

Ask the doctor

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Q. Is there something stronger than aspirin I can take for peripheral artery disease in my legs?

A. People with peripheral artery disease (PAD) in the legs have blockages (plaques of atherosclerosis) in the arteries that impair the flow of blood. Based on large scientific studies involving over 5,000 people with PAD, authorities recommend taking a daily aspirin tablet. For people with PAD, smoking cessation, regular exercise, and often other medicines such as statins, can help prevent further plaque buildup and decrease symptoms.

Sometimes attention deficit hyperactivity disorder is behind issues with memory and task completion.

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You may be concerned about your memory if you notice that you're struggling to keep track of items you use each day, getting sidetracked when doing chores and other tasks, and tuning out during conversations. But it could be that you have attention deficit hyperactivity disorder (ADHD), a brain wiring difference once recognized only in children. In adults, ADHD often produces problems with memory and attention rather than hyperactivity.

"Two to three percent of people in their 60s or older have traits of ADHD that are impairing," says Dr. Craig Surman, a neuropsychiatrist and ADHD researcher at Harvard-affiliated Massachusetts General Hospital and co-author of the Harvard Health Publishing book FASTMINDS: How to Thrive If You Have ADHD (or think you might).

On call

Q. For the past few months, I get dizzy when I turn my head quickly or bend over. What could cause this?

A. You most likely have a bothersome, but not serious, condition called benign paroxysmal positional vertigo. The symptoms are brought on by head movement. They can be quite mild, with just a few seconds of a spinning or off-balance sensation when the head moves a certain way, but some people experience severe dizziness, along with nausea and possible falling.

There are ways to shorten flare-ups and, in some people, prevent them from recurring.

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Psoriasis is a big star on TV drug ads, but this autoimmune skin disease is something most people try to keep well hidden.

"Psoriasis is among the most common skin conditions, affecting about 2% of the U.S. population, and while the condition doesn't affect everyone the same way, the approach to treatment and prevention is often similar," says Dr. Gideon Smith, an assistant professor of dermatology at Harvard-affiliated Massachusetts General Hospital.