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Gastritis: How can you prevent peptic ulcers caused by painkillers?

When taken for a long time, painkillers like diclofenac and ibuprofen can lead to ulcers in the stomach and bowel. But the risk of this happening can be clearly reduced by also taking medication to protect your stomach.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 1, 2015

Pain management in metastatic breast cancer

Pain – no matter how severe – can almost always be at least partly relieved through therapy. Well-coordinated pain management with regular adjustments is crucial for maintaining quality of life. It is one of the most important medical interventions used in metastatic breast cancer.Metastatic breast cancer treatment targets not only the cancer cells, but also the related symptoms such as pain and any possible side effects of more aggressive treatments.The symptoms caused by breast cancer will depend on various factors, including the size of the tumor and the rate at which it is growing. A growing tumor can cause pain if the cancer cells press against nearby nerves or damage healthy tissue. Large tumors may prevent organs from working properly if they grow into the chest wall or the skin. The location of metastatic tumors also influences the kind of symptoms they cause. For instance, if the lungs are affected, breathing may become difficult. Metastases in the bones can be painful and make the bones more fragile.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 7, 2016

Should you have your wisdom teeth pulled?

Some people believe that removing wisdom teeth is a waste of time if they are not causing any problems. Others think that the teeth will only cause trouble and have no real function anyway. There actually are good reasons for carefully considering whether you should have them removed.There are still many unanswered questions about wisdom teeth. This is one of the reasons why there are so many contradictory ideas about them. Some dentists recommend removing wisdom teeth no matter what – even if they are not causing any problems. Their reasoning is that the wisdom teeth will usually end up causing problems anyway and leave you with unattractive teeth. Another argument for removal is that we simply no longer need wisdom teeth.It has now become common to only recommend pulling wisdom teeth if they have already caused trouble or if problems are highly likely. Removing the teeth is quite unpleasant and may cause side effects. It has also not yet been proven whether pulling wisdom teeth that do not cause any problems has any possible health benefit. So it is a good idea to weigh the pros and cons of having an operation.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 18, 2014

Treatment for acute middle ear infections

Children who have an acute middle ear infection (acute otitis media) usually have earache and a fever. They sleep badly, are restless and cry a lot. As a result, parents often have sleepless nights too. But the infection usually clears up on its own within two to three days. What are the treatment options and when is it important to seek medical advice?Middle ear infections usually clear up after a few days. Complications are very rare. The earache often already goes away again after one day. Until that happens, children can use medication to relieve pain and reduce fever, such as ibuprofen and acetaminophen (paracetamol). A lot of care and attention can also help, and some people feel that certain home remedies have a soothing effect too.Antibiotics often do not work and can have side effects. So there is usually a good reason to wait two or three days at first, to see whether a middle ear infection clears up on its own. If the symptoms do not get better, the child can still take antibiotics then. Antibiotics also help in children who are leaking pus from their ear, and in children who are under two years old and have an infection in both ears.If a child is unwell it can be important to seek medical advice early on. The doctor can judge whether it is a middle ear infection and how severe it is. You can then discuss the most appropriate treatment approach together. If the symptoms do not get better despite treatment, or if the child has problems such as hearing loss, it is advisable to see the doctor again.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: December 1, 2016

Lasting pain after shingles

Pain that continues for a long time after a shingles rash has disappeared is called post-herpetic neuralgia. This is the most common complication of shingles. It’s still not clear how it can be prevented or what the best treatment is.Shingles typically causes a rash accompanied by pain in the affected area. The pain normally goes away when the rash goes away. This usually happens after two to four weeks. Pain that continues for longer is referred to as post-herpetic neuralgia. The word "post-herpetic" means "post-herpes" because the pain arises after infection by the herpes zoster (shingles) virus. In very rare cases pain can come back after a shingles infection, even if it had already gone away and the rash has disappeared.The main symptom of post-herpetic neuralgia is pain in the nerves (neuralgia). The skin is often overly sensitive and itchy as well. This can make it difficult or painful to wash yourself, turn over in bed, or hug someone. The pain and itching can be very severe and might keep you from sleeping.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

Asthma: Overview

Asthma is a disease in which the airways become so narrow that it is difficult to breathe, either temporarily or permanently. Nowadays asthma can be treated quite effectively, meaning that most people with asthma can manage their illness and live a life largely free of symptoms.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 25, 2014

What are the treatment options for heavy periods?

There are various treatment options available for women who have very heavy periods, including medication, hormonal contraceptives and surgery. Knowing about the advantages and disadvantages of each option can help make it easier to choose an appropriate treatment.If very heavy periods become too much of a problem, treatment can help you to cope better. Different types of medication can reduce the bleeding and related problems. If one medication doesn't work, it is usually possible to try out other kinds.Hormonal contraceptives like birth control pills or intrauterine devices (IUDs) affect the menstrual cycle and lessen the amount of bleeding. Any fibroids or polyps that are found to be the cause can be surgically removed. If the effects of heavy periods are particularly bad, other procedures can be considered.The choice of treatment and best time for treatment will depend on whether a woman is planning to become pregnant. The most effective treatments all limit a woman's ability to get pregnant – either temporarily, like the pill, or permanently, like the surgical removal of the womb (hysterectomy).But as long as the heavy periods aren’t causing anemia, they don’t necessarily need to be treated. Some women learn ways to prepare as well as possible for “heavier” days. But it’s a good idea to see a doctor and try to find out what the cause is.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 4, 2017

Gastritis: Overview

Gastritis is a common condition. Acute gastritis is accompanied by stomach pains, feeling full, heartburn, and nausea. Common causes of gastritis include an infection with bacteria and taking anti-inflammatory painkillers. Symptoms usually go away on their own after a few days.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 30, 2015

Medication for the treatment of rheumatoid arthritis

People with rheumatoid arthritis typically have permanent inflammation in several joints. The joints are painful and swollen, and gradually stiffen. Rheumatoid arthritis usually progresses slowly over many years. The aim of treatment with medication is to relieve the symptoms and prevent the progression of the disease as much as possible.In rheumatoid arthritis, various kinds of medication are used to relieve the symptoms, reduce the inflammation and to keep the joints working properly for as long as possible. There are two types of therapy: disease-modifying therapy and symptomatic therapy.Disease-modifying therapy: These medications are taken regularly for longer periods of time independent of any acute symptoms. They are known as “disease-modifying anti-rheumatic drugs” or “DMARDs” for short. Disease-modifying drugs inhibit inflammatory responses in the joints of people with rheumatoid arthritis. In this way they can at best stop – or at least delay – the progression of the disease, preventing damage to the joints. Their effect is often only noticeable after one to four months of treatment. DMARDs can be divided up into “conventional” and “biological” disease-modifying drugs.Symptomatic therapy: Medications used in symptomatic therapy are taken to relieve acute pain and inflammation. The main ones are non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen (also called paracetamol), and steroids (corticosteroids).

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: August 27, 2016

Shingles: Overview

If you've had chickenpox, you may get shingles. Both conditions are caused by the same virus. Having a weakened immune system – due to severe stress or old age, for instance – can increase the risk of developing this often very painful rash. It usually takes about two to four weeks for shingles to clear up.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 6, 2017

Treatment options for endometriosis

Although there is currently no cure for endometriosis, various things can be done to relieve the symptoms and improve quality of life. The choice of treatment mainly depends on whether the woman would like to become pregnant.A woman’s choice of endometriosis treatment will greatly depend on her personal situation. If symptoms like pain and cramping are the main problem, many different symptom-relieving treatments can be considered. These include painkillers, hormones or surgery. Hormone treatment is not suitable for women who would like to become pregnant, though.None of the available treatments are a guaranteed cure. It often takes some time before women find a treatment that provides enough symptom relief and has side effects that are acceptable to them.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 7, 2014

Migraine prevention in adults

The symptoms of migraine attacks can usually be relieved with painkillers or migraine medication. People who have migraines would usually prefer to stop them from happening in the first place, though. Keeping a migraine diary can help identify possible triggers. Preventive treatment can reduce the number of migraine attacks.Most people with migraine have a type known as episodic migraine, where the attacks occur more or less regularly. Fewer than 2% of people with migraine have a different type known as chronic migraine. This is where the migraine headaches occur on 15 or more days per month over a period of three months or more.Migraine attacks are very painful and can have a major impact on quality of life. Many people with migraine would like to do something themselves to prevent attacks from happening in the first place. A number of different preventive measures can be taken. For instance, some people try to avoid possible migraine triggers. Others learn relaxation techniques or try out an endurance sport. Taking preventive medicine every day is another option.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 18, 2015

Antithrombotic drugs to prevent further blood vessel blockage after bypass surgery using vein grafts obtained from the same person (autologous) or artificial grafts in the legs

Lower limb atherosclerosis can lead to blocked blood vessels causing pain on walking (intermittent claudication) or, if more severe, pain at rest, ulceration and gangrene (critical limb ischaemia).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Antiplatelet agents for preventing failure of peripheral arterial grafts

Symptomatic peripheral arterial disease in people with atherosclerosis can present as intermittent claudication, disabling pain on walking, or as critical limb ischaemia with pain at rest, ulceration, gangrene and the risk of losing a leg. One treatment option is to implant a graft or makeshift blood vessel to bypass a blockage in the main artery of the thigh. Using a section of the vein from the patient's leg is often better than artificial or prosthetic materials such as Dacron or polytetrafluoroethylene, which take up platelets that could lead to clotting that could block the graft. Other factors affecting the patency of the graft (how long the bypass remains open) include length of the bypass, site where the graft connects to the existing artery and blood flow out of the graft. Stenosis (narrowing) of the graft most frequently occurs at the surgical connections because of hyperplasia, or an increase in the number of smooth muscle cells, into the inner layer of the vessel, often followed by the formation of a thrombosis (clot) at the stenotic site.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Combining two or more drugs vs one drug for pain control in inflammatory arthritis

This summary of a Cochrane review presents what we know from research about the effect of a combination of two pain relieving drugs for pain control in inflammatory arthritis (IA).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Glycoprotein IIb‐IIIa inhibitors for acute ischaemic stroke

Question: We wanted to evaluate the safety and effectiveness of GP IIb‐IIIa inhibitors, alone or in combination with thrombolytic agents, in individuals with acute ischaemic stroke.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Adverse events after single doses of oral analgesics for acute pain after operation in adults

Acute pain is often felt soon after injury. Most people who have surgery have moderate or severe pain afterwards. Painkillers (analgesics) are tested in people with pain, often following the removal of wisdom teeth. In all these studies, the participants have to have at least moderate pain in order for there to be a sensitive measure of pain‐relieving properties. The pain is usually treated with painkillers taken by mouth. Results can be applied to other forms of acute pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Oral painkillers available without prescription for acute pain

Acute pain is often felt soon after injury, and is of short duration. Most people who have surgery have moderate or severe pain afterwards. Painkillers (analgesics) are tested in people with pain, often following the removal of wisdom teeth. Study participants have to have at least moderate pain levels and the pain is usually treated with painkillers taken by mouth. This overview is useful mainly for acute pain lasting only a few days or weeks, and not for chronic pain lasting for many months. For this overview we have not included information from reviews on migraine, tension headache, or period pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Paracetamol (acetaminophen) with or without an antiemetic for acute migraine in adults

This is an updated version of the original Cochrane review published in Issue 11, 2010 (Derry 2010). New searches identified one additional study for inclusion; this study compared paracetamol with etodolac and did not contribute to any of the analyses in the review.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Colorectal Cancer Prevention (PDQ®): Patient Version

Expert-reviewed information summary about factors that may influence the risk of developing of colorectal cancer and about research aimed at the prevention of this disease.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: February 8, 2017

Systematic Reviews in PubMed

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