Pancreatic Diseases

The pancreas is a gland behind your stomach and in front of your spine. It produces juices that help break down food and hormones that help control blood sugar levels. Problems with the pancreas can lead to many health problems. These include:

• Pancreatitis, or inflammation of the pancreas: This happens when digestive enzymes start digesting the pancreas itself
• Pancreatic cancer
• Cystic fibrosis, a genetic disorder in which thick, sticky mucus can also block tubes in your pancreas

The pancreas also plays a role in diabetes. In type 1 diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked them. In type 2 diabetes, the pancreas loses the ability to secrete enough insulin in response to meals.

Urinary Incontinence

What is urinary incontinence (UI)?

Urinary incontinence (UI) is the loss of bladder control, or being unable to control urination. It is a common condition. It can range from being a minor problem to something that greatly affects your daily life. In any case, it can get better with proper treatment.

What are the types of urinary incontinence (UI)?

There are several different types of UI. Each type has different symptoms and causes:

• Stress incontinence happens when stress or pressure on your bladder causes you to leak urine. This could be due to coughing, sneezing, laughing, lifting something heavy, or physical activity. Causes include weak pelvic floor muscles and the bladder being out of its normal position.
• Urge, or urgency, incontinence happens when you have a strong urge (need) to urinate, and some urine leaks out before you can make it to the toilet. It is often related to an overactive bladder. Urge incontinence is most common in older people. It can sometimes be a sign of a urinary tract infection (UTI). It can also happen in some neurological conditions, such as multiple sclerosis and spinal cord injuries.
• Overflow incontinence happens when your bladder doesn't empty all the way. This causes too much urine to stay in your bladder. Your bladder gets too full, and you leak urine. This form of UI is most common in men. Some of the causes include tumors, kidney stones, diabetes, and certain medicines.
• Functional incontinence happens when a physical or mental disability, trouble speaking, or some other problem keeps you from getting to the toilet in time. For example, someone with arthritis may have trouble unbuttoning his or her pants, or a person with Alzheimer's disease may not realize they need to plan to use the toilet.
• Mixed incontinence means that you have more than one type of incontinence. It's usually a combination of stress and urge incontinence.
• Transient incontinence is urine leakage that is caused by a temporary (transient) situation such as an infection or new medicine. Once the cause is removed, the incontinence goes away.
• Bedwetting refers to urine leakage during sleep. This is most common in children, but adults can also have it.
  • Bedwetting is normal for many children. It is more common in boys. Bedwetting is often not considered a health problem, especially when it runs in the family. But if it still happens often at age 5 and older, it may be because of a bladder control problem. This problem could be caused by slow physical development, an illness, making too much urine at night, or another problem. Sometimes there is more than one cause.
  • In adults, the causes include some medicines, caffeine, and alcohol. It can also be caused by certain health problems, such as diabetes insipidus, a urinary tract infection (UTI), kidney stones, enlarged prostate (BPH), and sleep apnea.

Who is at risk for urinary incontinence (UI)?

In adults, you are at higher risk of developing UI if you:

• Are female, especially after going through pregnancy, childbirth, and/or menopause
• Are older. As you age, your urinary tract muscles weaken, making it harder to hold in urine.
• Are a man with prostate problems
• Have certain health problems, such as diabetes, obesity, or long-lasting constipation
• Are a smoker
• Have a birth defect that affects the structure of your urinary tract

In children, bedwetting is more common in younger children, boys, and those whose parents wet the bed when they were children.

How is urinary incontinence (UI) diagnosed?

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms. Your provider may ask you to keep a bladder diary for a few days before your appointment. The bladder diary includes how much and when you drink liquids, when and how much you urinate, and whether you leak urine.
• A physical exam, which can include a rectal exam. Women may also get a pelvic exam.
• Urine and/or blood tests
• Bladder function tests
• Imaging tests

What are the treatments for urinary incontinence (UI)?

Treatment depends on the type and cause of your UI. You may need a combination of treatments. Your provider may first suggest self-care treatments, including:

• Lifestyle changes to reduce leaks:
  • Drinking the right amount of liquid at the right time
  • Being physically active
  • Staying at a healthy weigh
  • Avoiding constipation
  • Not smoking
• Bladder training. This involves urinating according to a schedule. Your provider makes a schedule from you, based on information from your bladder diary. After you adjust to the schedule, you gradually wait a little longer between trips to the bathroom. This can help stretch your bladder so it can hold more urine.
• Doing exercises to strengthen your pelvic floor muscles. Strong pelvic floor muscles hold in urine better than weak muscles. The strengthening exercises are called Kegel exercises. They involve tightening and relaxing the muscles that control urine flow.

If these treatments do not work, your provider may suggest other options such as:

• Medicines, which can be used to
  • Relax the bladder muscles, to help prevent bladder spasms
  • Block nerve signals that cause urinary frequency and urgency
  • In men, shrink the prostate and improve urine flow
• Medical devices, including
  • A catheter, which is a tube to carry urine out of the body. You might use one a few times a day or all the time.
  • For women, a ring or a tampon-like device inserted into the vagina. The devices pushes up against your urethra to help decrease leaks.
• Bulking agents, which are injected into the bladder neck and urethra tissues to thicken them. This helps close your bladder opening so you have less leaking.
• Electrical nerve stimulation, which involves changing your bladder's reflexes using pulses of electricity
• Surgery to support the bladder in its normal position. This may be done with a sling that is attached to the pubic bone.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Erectile Dysfunction

Erectile dysfunction (ED) is a common type of male sexual dysfunction. It is when a man has trouble getting or keeping an erection. ED becomes more common as you get older. But it's not a natural part of aging.

Some people have trouble speaking with their doctors about sex. But if you have ED, you should tell your doctor. ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. If you don't see your doctor, these problems will go untreated.

Your doctor can offer several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight, or stopping smoking may also help.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Heart Diseases

What is heart disease?

Heart disease is a general term that includes many types of heart problems. It's a type of cardiovascular disease, which means heart and blood vessel disease.

Heart disease is the leading cause of death in the United States, but there are ways to prevent and manage many types of heart disease.

What are the types of heart disease?

There are many different types of heart disease. Some you may be born with, called congenital heart disease. Other types develop during your lifetime.

Coronary artery disease (also called coronary heart disease) is the most common type of heart disease. It happens slowly over time when a sticky substance called plaque builds up in the arteries that supply your heart muscle with blood. The plaque narrows or blocks blood flow to the heart muscle and can lead to other heart problems:

• Angina - chest pain from lack of blood flow
• Heart attacks - when part of the heart muscle dies from loss of blood flow
• Heart failure - when your heart can't pump enough blood to meet your body's needs
• Arrhythmia - a problem with the rate or rhythm of your heartbeat

Other types of heart diseases may affect your heart valves or heart muscle (cardiomyopathy).

What causes heart diseases?

The causes of heart disease depend on the type of disease. Some possible causes include lifestyle, genetics, infections, medicines, and other diseases.

Who is more likely to develop heart diseases?

There are many different factors that can make you more likely to develop heart disease. Some of these factors you can change, but others you cannot.

• Age. Your risk of heart disease goes up as you get older.
• Sex. Some factors may affect heart disease risk differently in women than in men.
• Family history and genetics. A family history of early heart disease raises your risk. And research has shown that some genes are linked to a higher risk of certain heart diseases.
• Race/ethnicity. Heart disease is the leading cause of death in most racial and ethnic groups in the United States. However, certain groups have higher risks than others. This includes Black people, White people, and American Indian/Alaska Native people.
• Lifestyle habits. Over time, unhealthy lifestyle habits can raise your risk of heart disease. These can include:
  • Eating a diet high in saturated fats, refined carbohydrates, and salt.
  • Not getting enough physical activity.
  • Drinking too much alcohol.
  • Smoking and exposure to secondhand smoke.
  • Too much stress.
• Having other medical conditions can raise your risk of heart diseases. These conditions include:
  • High blood pressure.
  • High cholesterol levels.
  • Diabetes.
  • Obesity.
  • Autoimmune and inflammatory diseases.
  • Chronic kidney disease.
  • Metabolic syndrome.

What are the symptoms of heart disease?

Your symptoms will depend on the type of heart disease you have. You may not have symptoms at first. In some cases, you may not know you have heart disease until you have a complication such as a heart attack.

How are heart diseases diagnosed?

To find out if you have heart disease, your health care provider will:

• Ask about your medical history, including your symptoms
• Ask about your family health history, including relatives who have had heart disease
• Do a physical exam
• Likely run heart tests and blood tests

In some cases, your provider may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.

What are the treatments for heart disease?

Treatment plans for heart disease depend on the type of heart disease you have, how serious your symptoms are, and what other health conditions you have. Possible treatments may include:

• Heart-healthy lifestyle changes
• Medicines
• Procedures or surgeries
• Cardiac rehabilitation

Can heart diseases be prevented?

You may be able to lower your risk of certain heart diseases by making heart-healthy lifestyle changes and managing any other medical conditions you have.

NIH: National Heart, Lung, and Blood Institute

Retinal Disorders

What are retinal disorders?

Retinal disorders are conditions that affect the retina, the thin light-sensitive tissue at the back of your eye. The retina senses light and sends signals to your brain so you can see.

Retinal disorders can cause blurred or distorted vision. Some can lead to vision loss or blindness.

What causes retinal disorders?

The causes of retinal disorders vary. Aging is a common factor, but other things can raise your risk, such as if you:

• Smoke
• Have obesity
• Have health conditions like diabetes or high blood pressure
• Have had an eye injury or trauma
• Have a family history of retinal disorders

What are common retinal disorders?

Some common retinal disorders include:

• Macular degeneration. Occurs when the macula (the center of the retina that helps you see fine details) breaks down. There are two types: wet and dry macular degeneration.
• Diabetic retinopathy. Occurs when diabetes damages small blood vessels in the retina, causing them to swell or leak.
• Retinal detachment. Occurs when the retina pulls away from the back of the eye. This is a medical emergency.
• Retinal tears. A hole or break in the retina caused when the gel-like substance inside your eye (the vitreous) pulls away.
• Retinoblastoma. A rare cancer of the retina that most often affects young children.
• Macular pucker. Scar tissue that forms on the macula and distorts vision.
• Macular hole. A small opening in the macula, often related to aging or injury. It can blur or distort central vision.
• Eye floaters. Small specks, cobwebs, or threads that drift across your vision. These are more common with aging.
• Retina pigmentosa. A group of inherited disorders (passed down through families) that slowly damage the retina and cause loss of night and side (peripheral) vision.

What are the symptoms of retinal disorders?

Symptoms can vary, but most retinal disorders affect your vision. Common symptoms include:

• Blurred or distorted vision
• Loss of central or side (peripheral) vision
• Flashes of light
• Seeing floating specks or cobwebs
• Trouble seeing at night
• Sudden vision loss (in severe cases)

Seek medical care right away if you notice flashes of light, sudden vision changes, or a sudden increase in eye floaters. These can be signs of a serious retinal problem.

How are retinal disorders diagnosed?

Eye care providers check for retinal disorders with a dilated eye exam. Eye drops are used to widen your pupils so your provider can look at the retina for signs of damage.

They may also do other tests, such as:

• Optical coherence tomography (OCT) to take detailed pictures of the inside of your eye.
• Fluorescein angiography to check the blood vessels in your retina.
• Visual field tests to measure your side (peripheral) vision.

How are retinal disorders treated?

Some retinal disorders can be treated to slow or stop vision loss, and sometimes to restore vision. Treatment depends on the cause and severity. It may include:

• Laser therapy
• Medicine or eye injections
• Surgery
• Lifestyle management to control health conditions such as diabetes or high blood pressure

Can retinal disorders be prevented?

Not all retinal disorders can be prevented. Some are related to aging or genetics. But you can protect your eyes by:

• Wearing safety goggles or sunglasses
• Getting regular eye exams
• Making healthy lifestyle changes, such as:
  • Quitting smoking (or not starting)
  • Managing diabetes and blood pressure

NIH: National Eye Institute