I have lower right abdominal pain and anxiety?
I’ve been having lower right abdominal pain for a while now. Recently, it started to include really horrible anxiety (chest pains). I’m fourteen and have never had any problems with my heart. I went to the hospital three times and one of the times the doctor started to push on my lower left area. What does that mean? They said I was fine the first time, had anxiety the second time, and had costochondritis the third. I don’t think that explains the lower right pain. My mom has hyperthyroidism, could that be it? I have constipation and diarreah also. I’m so so afraid that I have something horrible. What’s wrong with me?
Junk in the bowel can cause all those problems. get your system cleaned out. One way to do it is to drink 2 quarts of warm water into which about 3 tsp of salt has been added first thing in the morning before breakfast. then about an hour later, you will live in the bathroom for a few hours, and much will come out. do that three or four days in a row, if you can miss school, or a few weekends in a row, and things will be clean. If you have appendicitis, you should do a colonic instead of a salt flush, for the salt flush can briefly increase abdominal pressure.
Effect of Shugan Jianpi Granule on Gut Mucosal Serotonin-positive Cells in Patients with Irritable Bowe Syndrome of Stagnated Gan-qi Attacking Pi Syndrome Type
WANG Zai-jian l, LI Hui-xia 2, WANG Jing-hua 1, and ZHANG Fan 1
ABSTRACT Objective: To evaluate the effect of Shugan Jianpi Granule , SJG) on the number of gut mucosal serotonin-positive cells (5-HT+C) in patients with irritable bowel syndrome (IBS) of stagnated Gan-qi attacking Pi (SGAP) syndrome type. Methods: Twenty-four patients were randomized equally into three groups. All were treated with the basic conventional treatment by cognition-behavior therapy with assistance of lactein 3 tablets thrice a day. Additionally, 24 g of SJG was given three times a day to group A, and the same dosage of SJG and Smecta 15 g thrice a day was given to group B, while no additional treatment was given to the control group. The number of 5-HT+C was measured respectively before and two weeks after treatment by immunohistochemical method. Results: The number of 5-HT+C decreased after treatment in all the three groups (P<0.05), but the decrement was more significant in the two test groups than in the control group (P<0.05 and P<0.01, respectively), while comparison of 5-HT+C between the two test groups showed insignificant difference (P>0.05). Conclusion: SJG can reduce the number of 5-HT+C in IBS patients of SGAP syndrome type, and its effect is enhanced when used in combination with Smecta.
KEY WORDS Shugan Jianpi Granule, irritable bowel syndrome, serotonin
Irritable bowel syndrome (IBS) is a clinical syndrome involving digestive functional changes without intestinal constitutive and biochemical abnormalities; that is, no pathologically based organic change could be found. Researches showed that the occurrence of IBS of the diarrhea type (IBS-D) is closely related with the abnormal secretion of serotonin, an intestinal neural transmitter related with mental psychic factor(1).
The Chinese drug Shugan Jianpi Granule SJG) possesses the actions of stretching Gan ,strengthening Pi regulating qi and activating blood circulation, and is commonly used for the treatment of diarrhea, abdominal pain, etc., caused by Gan stagnation, Pi deficiency and qi-blood stasis, and IBS of stagnated Gan-qi attacking Pi (SGAP) syndrome type is one of the indications of SJG.
This study was a controlled trial designed for evaluating the effect of SJG on the number of gut mucosal serotonin-positive cells (5-HT+C) in IBS patients of SGAP syndrome type by way of observing the change in the number of 5-HT+C before and after SJG treatment.
Diagnosis Standard and Clinical Materials
Patients with diagnosis of IBS-D up to the Rome ? standard(2), and with TCM syndrome of SGAP matching the standard in the integrative medical diagnosis and treatment program (draft)(3) were selected.
All the 24 patients enrolled were outpatients visiting the clinics of digestive medicine, the Third Hospital Affiliated to Beijing University of Chinese Medicine from March 2007 to August 2007. They were distributed into 3 groups equally according to the sequence of their visit. The 8 patients in group A were 4 males and 4 females, aged between 21-45 years, 31.8 ± 15.6 years on average, with the
disease course of 3-19 months, 13.1 ±8.7 months on average; the 8 patients in group B were 3 males and 5 females, aged between 28-39 years, 35.2±16.4 years on average, with the disease course of 4-28 months, 15.3± 12.7 months on average; the 8 patients in the control group were 4 males and 4 females, 18-46 years old, with the mean of 32.2±14.8 years. The three groups were insignificantly different in general conditions like age, sex, and course of disease (P>0.05).
Treatment was implemented by an appointed specialist trained by the neurological department. The basic therapy given to all patients in the three groups included mainly recognition-behavior treatment, with the auxiliary measures of diet-guidance and oral administration of lactein tablet, three times a day, 3 tablets each time.
Additionally, for patients in group A, SJG was given three times a day, 24 g each time, which is a Chinese medicine consisting of nutgrass galingale rhizome, white atractylodes rhizome, tangerine peel, notoginseng, etc., made by the pharmacy department of Beijing University of Chinese Medicine; for patients in group B, besides the SJG given to group A, 15 g of Smecta (a product of Bofu-Yipusheng Pharmaceutical Co., Ltd., batch No. H20000690) thrice a day was also given; no additional treatment was given to the patients in the control group. The observation period lasted over 2 weeks for all the three groups.
Indexes and Methods of Observation
Colonoscopic examination on fasting condition was performed in all patients before and after treatment to take 2-3 pieces of biopsy from the sigmoid-rectal conjuncture, and then the sample tissues were fixed by 4% formaldehyde, gradient alcohol dehydrated, dimethylbenzene hyalinized and paraffin embedded.
The paraffin embedded tissue was sectioned into 5 µ m successive slides, dewaxed in routine, managed with 3% H202 to block the endogenic peroxidase, rinsed with PBS, and incubated with 10% goat serum under 37? for 15 min. With the serum discarded, the sample was co-incubated with rabbit anti-human 5-HT multi-colony antibody (primary antibody, product of Zhongshan Company, China) under 37? for 1 h and under 4? overnight, then incubated in turn with 25-50 µg/mL biotin labeled secondary antibody (SP-9000, product of Zhongshan Company, China) under 30? for 40 min; followed by incubation with 25-50 µg/mL horse radish peroxidase labeled streptavidin, and after PBS rinsing, colored by 0.05% diaminobenzidine, terminated with water in time, hematoxylin stained, then hyalinized to make a neutral resin slide.
The blank negative control was made in the same procedure but PBS was used instead of primary antibody; the tissue of the appendix was used as the positive control.
The stained 5-HT+C presented principally in cell plasma, showed itself to be brown-yellow, yellow or jasmine, which indicated the different degrees of positive responses such as strong positive, positive and weak positive respectively. Cells failing to be colored were regarded as serotonin negative cells.
The number of 5-HT+C in 5 high power visual fields (upper, lower, left, right, and middle) in each slide was counted with an Olympus laser cofocusing scanning microscope type FV500, and their sum was brought into analysis.
Paired t-test was used for comparison of data before and after treatment in the same group, variance analysis for difference between groups, and X2 test for classified variable like age and sex. All were managed by SAS 6.12 software.
Changes in Immunohistochemical Figures
The positive colored site was mainly located at the plasma of glandular cells. Before treatment, 0-3 5-HT+C in each glandule with a few infiltration of lymphocytes and neutrophils around it could be seen in all samples of the three groups. After
treatment, the 5-HT+C and infiltration were reduced in all groups, but the reduction in group B was more significant, and the lymphocytes and neutrophils around the glandular organ were reduced significantly (Figure 1).
Comparison of the Number of 5-HT+C
The number of 5-HT+C in the three groups were different insignificantly before treatment (P>0.05), but it reduced in all groups after treatment, showing significant difference as compared with those before treatment (P<0.05). Inter-group comparison showed that significant difference was only shown in the
comparison between the control group and the two test groups (P<0.05, P<0.01), while insignificance was shown between the two test groups (P>0.05). However, the decrease in group B seemed rather more evident (Table 1).
IBS is one of the functional intestinal diseases often encountered. As a neuro-transmitter closely related with mental psychic factor, the action of 5-HT in IBS has been studied deeply. On the account that it is the main inflammatory mediator for intestinal secretion and abnormal feeling, many drugs for IBS treatment targeted on various subtypes of 5-HT receptors have been synthesized and effectively applied in clinical practice, among which, the 5-HT3 receptor antagonist displays a more prominent effect for IBS-D(1).
Through literature review, Gershon, et al(4) held that various degrees of 5-HT signal transmission abnormality exist in all IBS patients and other intestinal dysfunction patients, which might be the pathogenetic basis for IBS. Our previous study showed that gut mucosal concentration of 5-HT and its related neuro-endocrinal cells, as intestinal pheochromocyte, play an important role in the pathogenesis of IBS(5,6).
Traditional Chinese medicine (TCM) holds that IBS-D belongs to the categories of “loosing bowel”, “abdominal pain” and “melancholia”. For its pathogenesis, ancient doctors suggested the theory of “Gan-disease passing to Pi” in such ancient medical books as “Nan-jing and “Jingui Yaolue “; while recent reports indicated that the often seen TCM syndrome of IBS-D is stagnated Gan-qi attacking Pi, and other syndromes would always develop from it(7); Gan and Pi are acting and impacting mutually in the pathological process. The transporting and transforming function of Pi depends on the catharsis of Gan, its hyperfunction or hypofunction could induce the dysfunction of Pi to form the pathological basis of IBS-D.
SJG is a pure Chinese herbal compound medicine made on the basis of experiences accumulated for many years, which consists of ten odd kinds of Chinese drugs, such as nutgrass galingale rhizome, white atractylodes rhizome, tangerine peel and notoginseng, ect. SJG has the effects of smoothening Gan, strengthening Pi, regulating qi and activating blood circulation, and is applied in clinical practice for the treatment of diarrhea, abdominal pain and distention, poor appetite, etc. Experimental studies showed that SJG can regulate the concentration of mediators of inflammation of tissues in the animal model of ulcerative colitis to inhibit the inflammation of the intestinal tract(8); and compared with the Western medicine, the pure Chinese preparation has a better efficacy in treating patients with IBS-D, with fewer adverse reactions found(9).
On the basis of the syndrome differentiation criteria suggested by Chen ZS, et al(3), IBS patients of SGAP type matching the Rome ? diagnostic standard of diarrhea type were enrolled in this study. The results showed that before treatment, the numbers of 5-HT+C in the three groups were not different significantly. After treatment, although the number decreased in all the three groups, the decrement in the two test groups was more statistically significant than that in the control group, while the difference between the two test groups was insignificant. Accordingly, it was deduced that SJG possibly impacts on the genesis of IBS-D, but it is not the only influencing factor. SJG possibly plays its action through 5-HT+C, the vital endocrinal cell in 5-HT signal transmitting path, and the combining of SJG with Smecta might be cooperative and could enhance the effect on the path.
Besides, the number of 5-HT+C also decreased significantly in the control group, in which patients were treated with simple cognition-behavior therapy and diet-control, which further illustrated that the influencing factors on the gut mucosal 5-HT signal transmitting path might be multiple. This result coincides with the outcome of the authors’ previous study(6). Since it has been reported that the intestinal content of 5-HT in the fasting condition is different from that of postprandial(10), to avoid the influence of errors on the results, all the sampled biopsy for the test in this study were obtained in fasting condition.
All problems concerning changes of other cytokines and chemical mediators of gut mucosal 5-HT signal transmitting path in IBS patients, and molecular mechanisms that could affect the number of 5-HT+C remain to be further studied.
In sum, SJG, as a Chinese composite preparation for treatment of IBS patients of SGAP type or diarrhea type, might have an effect on the intestinal neuro-endocrinal network partly by way of influencing the number of gut mucosal 5-HT+C, thus realizing its clinical effect on patients. Besides, when SJG is used in combination with conventional recognition-behavior therapy and symptomatic treatment of Western medicine, it shows an apparent synergistic action on 5-HT+C.
1. Costedio MM, Hyman N, Mawe GM. Serotonin and its role in colonic function and in gastrointestinal disorders. Dis Colon Rectum 2007; 50:376-388.
2. Drossman DA. The functional gastrointestinal disorders and the Rome ? process. Gastroenterology.2006; 130:1377-13 90.
3. Chen ZS, Zhang WD, Wei BH, et al. Schedule for diagnosis and treatment for irritable bowel syndrome with integrative Chinese and Western medicine (Draft). Chin J Integr Tradit West Med (Chin) 2005;25(3):282-284.
4. Gershon MD, Tack J. The serotonin signaling system: from basic understanding to drug development for functional GI disorders. Gastroenterology 2007; 132:397-414.
5. Wang ZJ, Ouyang Q, Zou YG, et al. Comparison of mucosal serotonin content in patients with ulcerative colitis and irritable bowel syndrome. Chin J Intl Med (Chin) 2005;44(11 ):851-852.
6. Wang Z J, Ouyang Q, Wei B, et al. Alteration of intestinal mast cells in cases with overlap syndrome inside ulcerative colitis and irritable bowel syndrome. J Clin Intl Med (Chin) 2005;22(10):674-677.
7. Han MH, Chen TQ. Exploration on evolvement rule and syndrome differentiation of diarrea-predominant irritable bowel syndrome. Guangming J Tradit Chin Med (Chin) 2007;22(3):35-36.
8. Qin ZS, Wang Y, Zhao Y, et al. Effect of Shugan Jianpi Granule on VIP and IL-10 in rats with ulcerative colitis. Jilin J Tradit Chin Med (Chin) 2007;27(3):48-50.
9. Tao Y, Chen DM, Dong MX, et al. The clinical study on Shugan Decoction in treating diarrhea-predominant irritable bowel syndrome. Chin Arch Tradit Chin Med (Chin) 2007;25(10):2190-2193.
10. Atkinson W, Lockhart S, Whorwell P J, et al. Altered 5-hydroxytryptamine signaling in patients with constipation and diarrhea-predominant irritable bowel syndrome. Gastroenterology 2006; 130:34-43.
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I assume you’re here because you’re suffering from testicle pain, and just like other blokes with painful testicles you want to know why they’re sore and the best way to treat the problem. Or is your reason more a concern that the pain is caused by something more serious like testicular cancer. It’s perfectly natural for any man to worry about testicle pain with all the stories you hear, but its best you turn a deaf ear to hearsay. The only person you should listen too is you’re GP. Painful or swollen testicles can be a result of an injury, so pain in this area does not necessarily mean cancer. Not all cancers bring pain and testicular cancer is usually one of those. Pain or no pain, if you feel a lump in your testicle then you must see your doctor.
I understand for some guys having a stranger mess about with their mebs is not something they may relish, but holding back in seeking help – then these same men later down the line might have no choice but to allow a queue of strangers to be touchy feely with them. Guys just like women get easily embarrassed over having to show their private parts, but it has to be done, so pluck up your courage and seek medical advice if you have testicle pain.
Sudden, severe testicle pain shouldn’t be ignored
Testicle pain is soreness in one or both testicles which can spread to the lower abdomen. The testicles are the two rounded balls located inside the scrotum (sac.) Some conditions that affect the male will have him suffer from abdominal pain first before testicle pain kicks in. One condition to name is testicular torsion.
Testicular torsion causes testicle twisting. Due to distortion the blood supply is cut off and causes tissue to die. It is a very serious condition which requires urgent attention. The condition is mostly diagnosed in young men between ages of 10 to 20 years old
Let us take a look at what might be causing your testicle pain
Epididymitis is a condition which causes inflammation of the epididymis (a curved structure to the rear of the testicle where sperm ripens and is kept.) It can cause mild discomfort to the more severe. It’s typical to see the scrotum swell, turn red and feel warm. Epididymitis is the common cause of scrotal pain, and normally an outcome of a complication of a urinary system infection, and bacteria being primarily the cause. The sexually transmitted disease gonorrhoea was once listed as the chief cause. Over time things have changed and now it is more known to be brought about by chlamydia. Main symptom is inflammation of the ducts where sperm leaves the testicle. Another condition caused by bacteria, or virus, is Orchitis which is an inflammation of testicle tissue.
Swollen testicles (swelling) can occur because of many factors, and one to mention is fluid. There are many sorts of fluid collection:
Varicocele affects the veins in the scrotum causing them to become enlarged. These veins carry blood away from the testicles.
Spermatocele is fluid in the epididymis that forms a cyst which normally holds dead sperm cells.
Hydrocele is commonly found in newborns. (Fluid filled scrotum.)
Another obvious reason for testicle pain could be a hernia…which is a result of weakness in the muscular wall of the abdomen. Due to the weakness a ring of intestine can easily thrust through causing a lump to form on the outside. A large hernia located in the groin region can work its way down into the scrotum making it look chunkier. Soreness suffered is more abdominal pain rather than scrotal, and can worsen with bouts of coughing or sneezing. Surgery to repair underlying muscle weakness is called “herniorrhaphy.”
As with most conditions you have to be careful to what they might lead to if not treated right away. It’s imperative you act on the sighting of a lump in your testicle, inflammation, swelling and pain sooner than later. Testicular torsion the condition mentioned earlier can lead to infertility if treated to late, so early treatment is the best and only way you can help prevent this from happening to you.
If you’re testicle pain is caused by a minor injury or fluid buildup, then pain relief medicine might help ease soreness and reduce swelling if any.
Self help advice:
You can help support the scrotum by wearing a athletic supporter
Apply an icepack to the scrotum
Warm water helps reduce inflammation
Place a rolled towel under your scrotum when lying flat on your back
Take pain killers such as acetaminophen or ibuprofen.
Aspirin should not be given to children
It is always better to be safe than sorry, so should you experience severe or sudden pain in and around the groin, or you have damaged the scrotum though injury, or if you are physically sick then get medical attention.
You are not to ignore symptoms like
A lump in the scrotum
The scrotum is warm, red, or sore to the touch
Most men with problems that affect their penis, testicles and scrotum worry more over how the actual diagnosis of their condition is determined. This brings us back to the issue mentioned earlier about being embarrassed, and how men hate the idea of having someone they don’t know fiddle with their tackle. Medics in emergency rooms on a wide scale treat men in the thousands daily for penal conditions, and are there to treat and cure problems, and not ogle your bits. Your member and its two mates are just the same as the next blokes so doctors won’t be taking a blind bit of notice of how you’re John Thomas looks unless he/she has to examine three balls…so go get yourself checked.
There is nothing to fear when having a physical examination. Your GP will focus on the groin, testicles, and abdomen. To give an accurate diagnosis your GP will need to know a little about your medical background. He/she may ask questions like
How long have you had testicular pain
Is it one or both testicles that’s affected
Did the pain start suddenly
Is the pain regular or irregular
How bad is the pain
Is the pain easing or getting worse
Is there pain in the abdomen or back
Have you injured yourself
Have you had an infection
Have you been treated for an STD
Is there something in particular you do that makes the pain worse
Does the pain disappear with medication
What symptoms do you have (swelling, redness, urine color, high fever, or unexplained weight loss)
After your consultation with the doctor the following diagnostic tests may be carried out:
Ultrasound of the testicles
Inspection of prostate secretions
Treatment may include:
Untwisting of the testicle
Surgery to repair testicular torsion (if untwisting failed)
Antibiotics to clear infections
Surgical drainage or removal of an abscess (uncommon)
Surgery for a varicocele, a hydrocele, or spermatocele, more so if the varicocele is threatening infertility
If you have testicle pain then get it checked out. It may only take a pill popping course to remedy the problem.
If you come from my part of the world and you’re “feeling down” people tend to say that life’s one “Big Ball Ache”. So in you’re case it looks like you have both. So why not kill two birds with one stone and put a stop to you’re worrying and soothe them aching balls.
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Rid the pain from Swollen Testicles