Believed until as close as the late 1900s to possess healing properties as antidotes to various poisons, advancements in medicinal biology have since proven otherwise.

According to gastroenterologists, bezoars are, in fact, a buildup of partially digested or undigested material-both food and non-food particles-in the gastrointestinal tract that gradually form larger, tightly packed masses that can cause a blockage in the digestive tract if allowed to grow.

Types:

Bezoars commonly form in the stomach and sometimes in the small intestine, although large intestinal bezoars are rare as most items are often too small or inconsequential by the time that they reach the large intestine. Depending on the accumulated material, bezoars are divided into the following types:

1-Phytobezoars:

These are the most common type that are composed of indigestible food fibers, usually cellulose. These fibers generally come from fruits and vegetables like raisins, prunes, sunflower-seed shells, leeks, celery, beets, and pumpkins.

  • Diospyrobezoars:are particularly common phytobezoar subtypes that form from a collection of persimmon seeds. However, they only occur in areas where the fruit is either grown or widely available.

2-Trichobezoars:

Composed primarily of hair coated with decayed, undigested food particles, trichobezoars are also known as ‘hairballs’ and can weigh up to several kilograms. In toddlers, trichobezoars form due to ingesting carpet or clothing fibers.

However, the presence of trichobezoars in older individuals, mostly adolescent girls, might indicate Trichophagia; a psychological condition characterized by compulsive hair-pulling and swallowing. In severe cases, the compact hair fibers can even fill up the stomach and form a ‘tail’ into the small intestine.

3-Lactobezoars:

Made up of undigested milk protein mixed with mucus, lactobezoars are most common in infants and some toddlers.

4-Pharmacobezoars:

A common occurrence in older adults, pharmacobezoars are composed of undissolved medication.

5-Foreign Body Bezoars:

All bezoars composed of indigestible non-food items like paper, polystyrene foam plates and cups, and even parasitic worms are classified under this category. Foreign body bezoars are generally rare and mostly form in toddlers and younger children.

Symptoms:

In most people, bezoars do not completely block the digestive tract, therefore hardly presenting any symptoms. When they do occur, symptoms include:

  • Feeling full after eating very little
  • Abdominal pain or tenderness
  • Unexplained weight loss
  • Lack of appetite
  • Foul breath
  • Vomiting
  • Anemia
  • Nausea

Risk Factors:

Bezoars can form in people of all ages. And while foreign body and trichobezoars are born of habit or psychological issues, the following conditions increase the risk of phytobezoar development:

  • A previous gastric surgery that delays stomach emptying, like gastric band for obesity reduction, peptic ulcer removal, or a gastric bypass.
  • Decreased stomach size
  • Diabetes, end-stage kidney disease, and certain autoimmune disorders that prevent the stomach from emptying properly.
  • Excessive fiber consumption.
  • Being on constant mechanical ventilation.
  • Certain medications that slow stomach contractions

In older individuals, risk factors include::

  • No teeth or poorly fitting dentures that result in improper chewing or the inability to chew food at all.
  • Reduced stomach acid production (hypochloridria)

Aside from the presence of the above risk factors, bezoars are unlikely to develop in most individuals.

Bezoars in Children:

While older adults are at a higher risk of phytobezoar development, lactobezoars are generally only restricted to infants and some toddlers, with the following factors increasing the instance of bezoar development:

  • Dehydration
  • Premature birth and/or low birth weight resulting in an underdeveloped gastrointestinal tract
  • High-calorie baby formula consumption
  • Extra addition of thickening agents like pectin to baby formula.

Aside from trichobezoars, other bezoars are easily removable and rarely ever cause long-term health effects. Consult with your doctor if you suspect signs of a bezoar, or book an appointment with a top Gastroenterologist in Karachi, Lahoreand Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your gastrointestinal concerns.

Peripheral Arterial Disease, or PAD, occurs when problems with blood circulation (usually due to plaque buildup) cause the arteries supplying blood to the extremities to constrict, resulting in severely reduced blood flow to the legs.

Peripheral Arterial Disease often manifests as unbearable leg pain when walking, reduced sensation in the legs and feet, and thinner skin. This makes proper foot care an essential part of the daily routine of someone with PAD. Here’s how you can protect your feet, and avoid possibly irreversible complications:

1-Treat Foot Problems Promptly:

Fungal infections of the nails or skin, like athlete’s foot, may not be an issue for most, but for someone with PAD, they can result in skin openings to allow a secondary bacterial infection.

And since wounds take longer to heal due to reduced blood and oxygen supply, these infections may even lead to amputations in extreme cases. Therefore, treat any and every skin infection as soon as you see it.

However, avoid self-cutting or trimming painful corns or bunions, as you may accidentally cause another injury and infection. Un-healing ulcers may also develop over the area in some cases. Have them removed by a doctor instead.

2-Wash and Moisturize Regularly:

Wash your feet daily with warm water and a mild soap to reduce skin bacteria, especially after coming from outside, and pat dry. Follow with a moisturizer to prevent skin cracks and dryness.

However, avoid moisturizing between the toes to prevent fungal growth, as these areas often remain moist and are close together. For naturally dry skin, use non-alcoholic lotions.

3-Trim Properly:

Incorrectly or carelessly trimmed nails can form the perfect environment for fungal and bacterial growth, and even self-inflicted injuries. So, take care to always trim your nails straight across instead of in a rounded shape to keep them from accidentally cutting into the skin.

Also, avoid cutting them too short and never cut into the corners. In case of hard nails, try cutting them after bathing when they’re softer.

4-Wear the Right Shoes and Socks:

Opt for comfortable, well-fitting shoes with extra toe-room to avoid bunion growth, scraping, chafing, and calluses. This means avoiding narrow-toed shoes or shoes made from harder materials that may cut into the skin.

For extra protection, wear thick socks. However, make sure they are always dry before wearing, and opt for seamless socks to avoid any sores from skin rubbing against the seams.

5-Avoid Going Barefoot:

Not going barefoot outdoors, be it beaches or neatly-trimmed lawns, is a given with PAD due to the high risk of possible foot threats like glass, pebbles, wood splinters, and metal. However, it is also highly recommended to wear shoes while indoors to avoid possible threats like scattered toys. Even stubbing your toes against the furniture can cause an open wound and possible infection.

6-Avoid Temperature Extremes:

Keep your feet protected from cold temperature exposure by wearing thick socks, and avoid overexposure to heaters and open fires in case of possible burns. Abstain from putting heating pads and hot water bottles on your feet entirely.

7-Exercise:

The reduced sensation may make walking extremely difficult and painful, but regular exercise helps promote blood flow to the legs and conditions the muscles for efficient oxygen use.

Try small exercises like moving your feet in circles and wiggling your toes throughout the day, and incorporate active, low-impact exercises like walking, swimming, and bicycling into your daily schedule.

Start with 20-30 minutes sessions and gradually work up to 60 minutes for maximum blood flow. Additional blood flow facilitating measures include elevating your feet as much as possible when sitting or lying down, and avoiding tight socks and stockings.

8-Stop Smoking:

This may not be directly related to foot care, but quitting smoking can prevent the arteries from further constriction and damage, hence keeping the numerous PAD-related complications at bay. Consult with your doctor if quitting on your own is difficult.

Self-care is a major component of PAD treatment. So, regularly inspect the tops, sides, soles, and heels of your feet along with checking between your toes for any signs of injury, cracking or dryness, and treat them promptly. Consult your doctor immediately if a leg or foot is pale, blue, numb, cool to the touch, red, hot or swollen, or if you experience persistent leg pain accompanied by chest pain or shortness of breath even when not moving, or observe any signs of infection.

You can also book an appointment with a top Orthopedic Specialist in Lahore, Karachi and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your peripheral concerns.

In children, growth disorders define any number of medical conditions that affect growth; from height and stature to delayed puberty. For some, these growth disorders are also accompanied by other issues, like organ dysfunction and uneven limbs, among others.

While most growth disorders are rooted in hormonal imbalances and congenital defects, here are some other common types and causes of growth disorders in children. Consult a pediatrician for growth problems treatment in children.

Bone Diseases:

Since bones are a key height-determining factor in children, any defect in bone growth can negatively affect height and stature development. Some bone-related growth disorders include:

1-Disproportionate Short Stature:

Also known as ‘Dwarfism’ or ‘hypochondroplasia’, this condition occurs when the bones and cartilage of different areas of the body either too slow or doesn’t grow entirely. In the affected children, either the limbs (short-limbed dwarfism) or torso (short trunk dwarfism) are much shorter in comparison to the rest of the body. The condition is often inherited.

2-Skeletal Dysplasia:

Like disproportionate short stature, skeletal dysplasia or ‘Chondrodystrophy’ also results in an abnormally short stature due to the malformation and abnormal growth of bones and cartilage. However, the condition has no known cause; It may be inherited or the result of negative physical changes like organ issues in children as they grow.

3-Achondroplasia:

Achondroplasia is a more severe form of hypochondroplasia in which the arms and legs are short in relation to the total body length despite a normal-sized trunk/torso. The head is also often slightly enlarged with an underdeveloped nasal area.

Genetic Disorders:

In addition to hormonal imbalances , some children inherit growth deficiency disorders from their parents, while in others, a malformation in certain genes can negatively affect growth. Some common genetic growth disorders include:

1-Turner Syndrome:

The X and Y chromosomes define female and male characteristics in the fetus (unborn baby) and are present in pairs. In young girls, Turner’s syndrome occurs when one x chromosome is either absent or defective, leaving the ovaries (egg and female hormone-producing organs) unable to develop, mature, and function properly. This results in a comparatively shorter height and failure to develop during puberty (the age where male and female sexual organs develop).

2-Marfan Syndrome:

As opposed Turner Syndrome, Children with Marfan Syndrome have abnormally long legs and arms with a proportionally shorter torso. Those affected with the condition also often experience heart and eye problems due to the sudden growth spurts that affect the other organs’ functioning.

Other Non-Medical Disorders:

While not classified as growth-affecting disorders in themselves, the following conditions often result from a wide variety of causes, and often indicate an underlying medical condition:

1-Familial Short Stature:

If short stature runs in the family or if both parents are of relatively smaller height, then all children born to such parents are usually also short-statured. They may have growth spurts and enter puberty at a normal age (9-13 for girls and 10-14 for boys), but only grow up to their parents’ average height. However, unlike other growth disorders, the condition does not present any disease-related symptoms or negative impact overall growth.

2-Constitutional Growth Delay:

Children who look small for their age and enter puberty later than their peers, but are actually growing at a normal rate are generally classified under this condition. This is because of a delayed ‘bone age’, i.e. their skeleton grows slower than their actual age. However, they continue to grow slowly even after their peers reach adult height; with most growing taller than other people their age, hence the name ‘Late-Bloomers’.

3-Precocious Puberty:

In contrast to constitutional growth delay, boys and girls who start showing signs of puberty, namely sexual organ development and growth spurts, before ages 9 and 8, respectively are said to be undergoing precocious puberty. However, while they may appear taller at first, children with condition often stop growing earlier than their peers, and are often average or below-average in height as adults.

Most growth disorders in children can be resolved through synthetic Human Growth Hormone (HGH) injections. However, consult with a doctor if you observe other physical symptoms alongside your child’s growth issues.

You can also book an appointment with a top Pediatrician in Lahore, Karachi and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your child’s growth-related concerns.