Co-occurrence of depression and chronic diseases

INTRODUCTION Depression is a common and serious mood disorder mainly manifested by sadness, anhedonia, lack of hope and interest in activities once enjoyed. According to WHO depression is a leading cause of disability and inability to work worldwide. Chronic disease is every condition lasting more than 1 year and requiring medical attention. The aim of this article is to show challenges of depression and chronic diseases coexistence. DISCUSSION Depression might be a factor causing difficulties in diagnosing chronic diseases as patients are less likely to cooperate. On the other it might lead to worse compliance and higher risk of chronic diseases’ development. Studies show depression coexisting with chronic illnesses is a valid problem for public health and aggravates the course and effects of treatment of those conditions. Treating an underlying disease is as important as treating depression itself as it might lead to reduction in symptoms of depression. Moreover doctors should choose drugs having regard to depression as well as lingering conditions. SUMMARY Depression still seems to be diminished and ignored in patients with chronic illnesses even though it is proved to have a destructive influence on the health of patients. It is of high importance to raise an awareness of doctors on that subject and its scale.  There are plenty of treatment methods for depression in case of chronic diseases co-occurence which gives hope for improving a quality of life of patients and achieving better effects of therapy of an underlying disease

Celiac disease and non-celiac gluten sensitivity – characteristics and differences

Introduction Celiac disease is a quite common condition resulting from the interaction of genetic, immunological, and environmental factors, with the main environmental factor being exposure to gluten. Non-celiac gluten sensitivity (NCGS) affects individuals without celiac disease or wheat allergy and is characterized by intestinal and extraintestinal symptoms related to the consumption of grain products, without accompanying damage to the intestinal mucosa. Discussion Gluten is a grain protein that is resistant to digestive enzymes and accumulates in the intestines, leading to tissue damage and the release of tissue transglutaminase 2 (tTG2) enzyme, which increases gluten immunogenicity. The presence of HLA-DQ2 or HLA-DQ8 gene variants in the genome is a necessary condition for the development of the disease, but it does not always lead to celiac disease. The pathomechanism of non-celiac gluten sensitivity is not yet fully understood. Diagnosis of celiac disease involves serological tests, genetic tests, and histological examination. Conclusions The only effective treatment for celiac disease is a strict gluten-free diet, which involves eliminating wheat, rye, barley, and triticale from one's diet. Further research is necessary to search for effective therapies. The approach for NCGS involves introducing an appropriate diet - either low FODMAP or gluten-free

Irritable bowel syndrome – modern ways of treatment

Introduction Irritable bowel syndrome (IBS) is the most frequent functional disorder of the gastrointestinal tract.  Main symptoms are recurring stomach ache connected with defecation, changes of frequency of defecation and/or stool’s consistency. Cause of IBS is still unknown unlike its pathomechanism. Continuous research allows doctors to understand and treat it better. Discussion Diagnosing IBS might be difficult even for the most experienced doctors due to its uncharacteristic symptoms. Therefore diagnosis should be made by using Rome IV Criteria. IBS is divided into 4 subtypes  basing on clinical picture: IBS with predominant constipation, IBS with predominant diarrhea, IBS with mixed bowel habits and IBS unclassified. Classification is being performed with the use of Bristol Stool Chart. Choice of remedy should be made depending on the subtype of IBS. Pharmacological treatment is symptomatic and focuses on relieving pain, diarrhea, constipation and bloating. Drugs that can be used are: loperamide, rifaximin, antispasmodic (e.g. hyoscine), antidepressants or laxatives. Treatment should also contain nonpharmacological methods. Nonpharmacological techniques which are proved to help patients contain regular physical activity, body mass reduction, low-FODMAP diet, using probiotics, psychotherapy and supplementing soluble fibre. Conclusions IBS is a big issue for public health as it is lowering quality of life and is generating big indirect costs. Difficulties in diagnosing are increasing those costs. That’s why it is of high importance to find more effective therapy. Raising awareness among doctors is crucial as plenty of methods are available to treat the disease which allows to reduce symptoms and costs

Common therapeutic approaches in sleep and awake bruxism — an overview

Bruxism, a common medical condition characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible, can occur during sleep, when it is known as sleep bruxism (SB), or during wakefulness, when it is known as awake bruxism (AB). Although bruxism often causes headaches, temporomandibular joint pain, masticatory muscle pain, mechanical tooth wear, prosthodontic complications and cracked teeth, there is still not enough data to define and support a standardised approach to its treatment. The aim of this review was to present the pathophysiology, consequences, types and treatment methods of bruxism in order to increase readers’ knowledge of this topic. Differences between awake and nocturnal bruxism are included, as well as risk factors and indicators visible during the clinical examination of affected patients. Among the causes we consider are genetics, stress, oral parafunctions and changes in the Central Nervous System (CNS). Potential and common methods of treatment are presented, along with suggested guidelines that should be followed when determining an appropriate treatment method. We draw attention to the notably dynamic development of bruxism in today’s society and the importance of informational and preventive projects, especially those targeted at high-risk patients as well as those targeted at specialists, in order to better tackle the bruxism ‘epidemic’