Diseases of the elderly

In the elderly, the following diseases are more common.

Arterial hypertension is a stable increase in blood pressure above 140/90 mm Hg. Art. Genetic factors and environmental factors play a leading role in the development of arterial hypertension. The external risk factors include: age over 55 years in men, over 65 years in women, smoking, cholesterol increase above 6.5 mmol / L, unfavorable family history of cardiovascular diseases, microalbuminuria( with concomitant diabetes), susceptibility disorderglucose, obesity, high fibrinogen, low-active lifestyle, high ethnic, socio-economic, geographical risk.

In the elderly, arterial hypertension arises more often as a result of an atherosclerotic lesion of blood vessels( the aorta, coronary arteries, and cerebral arteries are most often affected).

Atherosclerotic hypertension is isolated - it is hypertension in elderly patients, at which systolic blood pressure rises predominantly, and diastolic blood pressure remains at a normal level, which leads to a large difference between systolic and diastolic pressure. The increase in systolic blood pressure at normal diastolic pressure is due to the presence of atherosclerosis in large arteries. When the aorta and arteries are affected by atherosclerosis, they become not sufficiently elastic and to some extent lose the ability to stretch into the systole and contract to the diastole. Therefore, when measuring blood pressure, we fix a large difference between systolic and diastolic pressure, for example, 190 and 70 mm Hg. Art.

In the classification of arterial hypertension, 111 degrees of increase in blood pressure are isolated.

I degree: blood pressure numbers 140-159 / 90- 99 mm Hg. Art.

II degree: blood pressure numbers 160-179 / 100 - 109 mm Hg. Art.

III degree: blood pressure numbers above 180/110 mm Hg. Art.

Clinic

With increasing blood pressure, patients are concerned about headache, dizziness, there may be tinnitus, flashing of "flies" before the eyes. However, it should be noted that intense headache, accompanied by dizziness, nausea, tinnitus, is observed with a significant increase in blood pressure figures and may be a manifestation of hypertensive crisis. Also patients can be disturbed by frequent heartbeats( usually a sinus tachycardia), various pains in the region of the heart.

In elderly patients with atherosclerotic hypertension, objective symptoms, such as headache, dizziness, are not detected. Most complaints arise with a significant increase in blood pressure figures.

Often elderly and senile patients do not experience unpleasant symptoms with a significant increase in blood pressure figures, patients can feel good at arterial pressure of 200 and 110 mm Hg. Art. The diagnosis of arterial hypertension in such patients is often made with the occasional detection of high blood pressure( with a medical examination, hospitalization with another disease).Many of them believe that the absence of unpleasant sensations at high pressure indicates a benign course of the disease. This belief is fundamentally wrong. This latent( latent) course of hypertension leads to the fact that a person, without experiencing painful, painful symptoms, has no incentive to be examined and treated, as a result, hypotensive therapy is started by such patients late or not at all. It is now proved that the risk of developing vascular accidents( myocardial infarction, acute cerebrovascular accident, thromboembolism) in such patients is much higher than in people who have normal blood pressure figures.

Features of blood pressure measurement in elderly patients: elderly people can have a pronounced thickening of the wall of the brachial artery due to the development of an atherosclerotic process in it. Therefore, it is necessary to create a higher level of pressure in the cuff for compression of the sclerosed artery. As a result, false overstating of blood pressure figures occurs, the so-called pseudohypertension.

Phenomenon of pseudohypertension is detected by Osler's intake, for this purpose arterial pressure on the brachial artery is measured by the palpatory and auscultatory method. If the difference is more than 15 mm Hg. Therefore, the phenomenon of pseudohypertension is confirmed. True blood pressure in these patients can only be measured by an invasive method.

Orthostatic hypotension may also occur in older people, so blood pressure should be measured in prone position.

Arterial hypertension requires constant treatment, regular intake of medications. Patients with hypertension are primarily active motor system, rational nutrition, observance of the regime of work and rest, control over body weight, refusal from alcohol, smoking. Consumption of table salt per day is no more than 4-6 g.

In the treatment of arterial hypertension, various groups of drugs are used, mainly ACE inhibitors( captopril, enalapril, prestarium, losinopril), diuretics( hypothiazide, furosemide, indapamide), betablockers( atenolol, anaprilin, egilok, concor), diuretics( furosemide, hypothiazide, indapamide), sedatives( valerian, passifit, afobazol).A combination of these groups of drugs is often used. Arterial hypertension in elderly patients is long, but benign, than hypertensive disease at a young age.

Angina pectoris is one of the most frequent forms of coronary heart disease. The main symptom is typical pain in angina pectoris - a pressing, compressive pain behind the sternum, which occurs with low physical exertion( walking 200-1000 m, depending on the functional class), resting at rest or sublingual nitroglycerin intake in 3-5 minutes. This pain can irradiate under the left scapula, in the shoulder, jaw. Such coronary pain occurs when there is insufficient supply of oxygen to the heart muscle, when the need for it is increased( for example, with physical exertion, emotional overstrain).An attack of angina may also occur when walking in cold windy weather or when drinking a cold drink. Usually the patient knows about the load of an attack of angina: what distance can he go, what floor to rise. Such patients should always have nitrate-containing drugs.

It should also be remembered about the so-called unstable angina, in which an attack of chest pain can dramatically change its nature: the distance a patient can go without pain, the effective nitroglycerin will cease to function, or it will have to be increased in order to stop pain. The most dangerous thing is when the pain starts to appear at night. Unstable angina is always regarded as a pre-infarct condition, and such a patient needs immediate hospitalization in a hospital. With severe pain syndrome, the patient should be given nitroglycerin by the tongue, do not give the patient several tablets at once or give them continuously: 1-2 tablets should be given, wait 10-15 minutes, then another, wait 10-15 minutes again,e. Large doses of nitroglycerin can be given only by controlling blood pressure - it should not decrease.

Prolonged course of angina, inadequate treatment or lack of it can subsequently lead to the development of heart failure, myocardial infarction.

It is necessary to know that not all pains in the region of the heart can be of stenocardic origin. Often in elderly patients, common pains to the left of the sternum are noted, which are permanent, aching, intensifying in certain movements. When probing along the rib or spine, painful points can be identified. Such pains are characteristic for osteochondrosis, intercostal neuralgia, myositis. Sometimes they worsen against the background of colds. Such pains are well treated with non-steroidal anti-inflammatory drugs( eg, diclofenac, ibuprofen).Sometimes chest pains appear after a tight meal, after the person who has eaten has laid down in a bed. Such pain can occur due to bloating( Remgelt's syndrome) and the associated diaphragm stress. Also in the elderly, a diaphragmatic hernia is quite common, when the esophageal opening of the diaphragm expands and in the horizontal position a part of the stomach moves to the chest cavity. There are pains that go in an upright position. Patients may be half asleep due to pain.

In women in menopause, along with typical symptoms such as a hot flush, a sense of crawling along the limbs, a sense of anxiety, unmotivated bouts of shivering, there may also be a variety of pains in the heart area. Usually they are not related to physical activity, but on the contrary, they often arise at rest, they can disturb for quite a long time, they do not pass for hours. Relieve these pains usually help valocordin, corvalol, valerian, while taking nitroglycerin on them does not affect.

Treatment of angina pectoris mainly involves the intake of a group of drugs, such as nitrates. Nitrates include nitroglycerin, nitrosorbide, and erinite. The intake of these drugs can cause a severe headache, in order to reduce this unpleasant side effect, nitrates are taken together with Validol. Also for the treatment of drugs used to reduce cholesterol, - statins( they include vasilip, atorvastatin), drugs that reduce the viscosity of the blood, - anticoagulants( aspirin, thromboass, cardiomagnet).

Heart failure is a pathological condition due to the weakness of the contractile activity of the heart and the lack of adequate blood circulation. Heart failure is usually a secondary condition that complicates the primary damage to the heart, vessels, or other organs. Causes of heart failure are the following diseases: IHD, heart disease, arterial hypertension, myocarditis, dystrophic changes in the myocardium, myocardiopathy, diffuse lung disease.

In the initial stages of heart failure, the ability of the heart to relax is disturbed, diastolic dysfunction occurs, the left ventricle chamber is filled with blood less, which leads to a decrease in the volume of the ventricle ejected. However, at peace the heart manages, the volume of blood compensates for the needs. During exercise, when the heart rate increases, the total discharge of blood decreases, and the body begins oxygen starvation, and the patient develops weakness, dyspnoea at any physical exertion. Heart failure is characterized by a decrease in the tolerability of the patient's usual physical activity.

Isolate acute and chronic heart failure.

Acute left ventricular failure develops against the background of a load on the left ventricle( this may include arterial hypertension, aortic malformations, myocardial infarction) and in the presence of a provoking factor, such as physical and emotional loads, infections.

Clinically acute left ventricular failure is manifested in the form of cardiac asthma or pulmonary edema.

Cardiac asthma develops sharply, manifested by increasing shortness of breath, a feeling of lack of air, suffocation. In addition to these symptoms, a cough may appear with the discharge of light sputum first, and then blood veins may appear in it. When auscultation in the lungs, hard breathing is heard, in the lower sections - wet small bubbling rales. The patient sits in bed with his legs down, this position facilitates the patient's condition due to discharge of a small circle of blood circulation. If there is no treatment and the disease progresses, pulmonary edema may develop.

Pulmonary edema can develop not only with left ventricular failure, but also with pneumonia, the appearance of foreign bodies in the bronchi, a sharp decrease in atmospheric pressure. Pulmonary edema is an acute condition requiring urgent care, as the symptoms develop so violently that an unfavorable outcome can occur quite quickly. Suddenly, often at night, against a background of an attack of angina in the patient there is a sharp shortness of breath( right up to suffocation), there is a dry cough that quickly changes to wet with the separation of frothy bloody sputum. The patient takes a forced semi-sitting or sitting position, lowering his legs, resting his hands on the bed, a chair, breathing assist muscles. There comes a general excitement, a feeling of fear of death. The skin becomes cyanotic. In the lungs, in all fields, damp, various-throat rales are heard, the frequency of respiratory movements increases to 40-45 respiratory movements per minute.

The course of pulmonary edema is always severe, the prognosis is very serious. Even with a positive result, a relapse of the condition is always possible during treatment.

In the treatment of acute left ventricular failure, sublingual administration of 10 mg nitroglycerin tablets is administered every 10 minutes, blood pressure monitoring, intravenous narcotic analgesia( 1-2 ml of 1% morphine), intravenous diuretic drugs( 2.0-8.0ml of a 1% solution of furosemide), intravenous administration of cardiac glycosides, it is preferable to administer strophanthin or corglitin in small doses( 0.25-0.5 ml of a 0.05% solution), combining them with potassium and magnesium preparations to improve the metaolizma in the myocardium.

Chronic heart failure develops gradually, often its causes are arterial hypertension, ischemic heart disease, aortic malformations.

The clinic for chronic heart failure has three stages.

At the first stage, general symptoms predominate: weakness, rapid fatigue, increased dyspnea, heart rate increases more often with physical activity. Occasionally, acrocyanosis may appear. The dimensions of the liver do not change. All these phenomena pass independently after the termination of physical activity.

In the II stage, all the symptoms begin to occur even with less physical exertion: dyspnea increases, tachycardia increases, a dry cough may appear. There are local symptoms( acrocyanosis), swelling of the lower extremities is observed, which do not pass in the morning, in the future swelling may increase( up to the development of anasarca - the presence of fluid in all cavities: ascites, hydrothorax, hydropericardium).The liver increases in size, becomes dense. In the lungs, humid finely bubbling rales are heard. When the state is decompensated, the patients are in a forced position: they sit in bed with their legs flat.

In the III stage( final, dystrophic) against a background of pronounced total stagnant insufficiency, severe irreversible changes in internal organs develop with a violation of their function and decompensation. Renal, hepatic insufficiency develops.

Non-pharmacological treatment consists in limiting physical activity, correction of water-electrolyte metabolism. Bed rest and restriction of the intake of liquid and table salt are necessary. Daily diuresis should be taken into account, the patient should keep a diary of accounting for the amount of drunk and excreted liquid. Determining the amount of liquids drunk per day, it is necessary to take it into account in all the products taken by the patient.

In case of medical treatment, it is necessary: ​​

• treat the underlying disease that led to CHF( etiologic therapy);

• increase the reduced contractility of the left ventricle( cardiac glycosides);

• reduce the increased volume of circulating blood( diuretics, vasodilators);

• eliminate or reduce peripheral edema and congestion in internal organs( diuretics);

• Reduce blood pressure( ACE inhibitors);

• Reduce the heart rate( beta blockers, cardiac glycosides, verapamil);

• Improve metabolic processes in the myocardium, increasing its contractility( potassium, magnesium, riboxin preparations).

Among all disorders of rhythm, especially often in old age, there is atrial fibrillation and a complete blockade of the conduction system of the heart. These two rhythm disturbances are dangerous and can lead to serious complications, which in turn can lead to death. Atrial fibrillation can occur at any age, but its frequency increases with age, but the complete blockade of the conduction system of the heart is exclusively a disease of the elderly.

Atrial fibrillation is a frequent irregular activity of the atria. It occurs when electrical impulses emanating from the "driver" of the rhythm in the right atrium begin to wander through the conduction system of the heart, develop or mutually cancel each other, with chaotic contractions of individual groups of atrial fibers with a frequency of 100-150 beats per minute. This pathology occurs more often with organic damage to the heart: cardiosclerosis, cardiomyopathy, heart disease, coronary heart disease. The onset of atrial fibrillation may also occur when additional conduction beams are detected( this is a congenital defect, usually recognized at a relatively young age).

With a complete blockade of the conduction system of the heart, the impulse from the atrium does not reach the ventricle. This leads to the fact that the atria contract in their rhythm, and the ventricles - in their own, much more rare than usual. At the same time, the heart stops responding by increasing the contractions in response to the need( for example, with physical exertion).Atrial fibrillation may be constant and paroxysmal.

Paroxysmal form is characterized by the fact that against a background of some provoking factor( such as: physical stress, emotional overstrain) there is an attack of frequent arrhythmic palpitation. At this point, the patient feels subjectively a feeling of disruption in the work of the heart, shortness of breath, weakness, sweating. Such an attack can take place either alone at rest, or when taking medications - in this case, the sinus rhythm is restored. Also, in some cases, you can try to eliminate the attack, strongly pressing on the eyeballs or painfully massaging the supraclavicular area, quickly putting the patient on his haunches. Such techniques can positively affect cardiac activity( up to the disappearance of arrhythmia).

The constant form of arrhythmia is characterized by the presence of a constant arrhythmic heartbeat, the sinus rhythm with this form is not restored. In this case, they ensure that the rhythm is not rapid - no more than 80-90 beats per minute. With a constant form of atrial fibrillation, the patient always feels irregularities in the work of the heart, dyspnoea with physical exertion. In the study of the pulse, pulse waves of different filling, nonrhythmic, are determined. If you compare the heart rate and heart rate, you can identify the difference between them in the direction of increasing the heart rate. This phenomenon is called a "pulse deficit" and determines the ineffectiveness of a part of the heart contractions - the chambers of the heart do not have time to fill up with blood, and an empty "cotton" occurs, respectively, not all contractions are carried out to peripheral vessels.

Prolonged flow of a constant form of atrial fibrillation leads to progression of heart failure.

In the treatment of atrial fibrillation, cardiac glycosides are used: korglikon, digoxin;beta blockers: atenolol, concor;cordarone isoptine, ethacyzine.

With complete blockade of the conductive ways of the heart, blood pressure suddenly decreases, the heart rate decreases - up to 20-30 beats per minute, the symptoms of heart failure increase. Patients with a newly diagnosed complete heart block are in need of mandatory hospitalization, since in this case it is possible to miss the development of myocardial infarction. Currently, the treatment of this pathology is to install the patient an artificial pacemaker, which, by generating electrical discharges, over the wiring inserted into the heart through the vein, stimulates the heart contractions. An artificial rhythm driver is sewn to the patient for 5-8 years. Such a patient should be away from areas with high magnetic fields( industrial transformers, high-voltage power lines, the use of radiotelephone and cellular communication, etc.), it can "interfere" with the reception of radio and television programs if it is close to the antenna.

Chronic bronchitis is an inflammatory diffuse lesion of the bronchial tree. The cause of the development of bronchitis are viral and bacterial infections, exposure to toxic substances, smoking. In the elderly, chronic smokers often suffer from chronic bronchitis.

Chronic bronchitis, like any chronic disease, occurs with periods of remission and exacerbation, which occurs more often in the cold season. During an exacerbation of the disease, the patient is disturbed by coughing( dry or with sputum discharge), shortness of breath when walking, fever to subfebrile digits, weakness, sweating. With auscultation, hard breathing is heard, dry wheezing in all fields of the lungs. The constant course of chronic bronchitis, the lack of adequate treatment, the presence of a constant irritating factor lead subsequently to the development of emphysema, pneumosclerosis, pulmonary heart development.

The treatment should first of all eliminate irritating and provoking factors. The patient needs bed rest. The following groups of drugs are used: antibacterial drugs, expectorants( mucaltin, bromhexine), herbal decoctions( thoracic collection No. 3, 4), nonsteroidal anti-inflammatory drugs( aspirin, ortafen, nise).

Often, prolonged course of chronic bronchitis leads to the development of chronic obstructive pulmonary disease. The disease is characterized by the presence of dyspnea, dry paroxysmal painful cough. After the departure of sputum, the patient's condition improves, it becomes easier for him to breathe. Locally, acrocyanosis can be noted, often the color of the skin is earthy, fingers in the form of tympanic sticks and nails in the form of hourglasses. Auscultatory in such patients, hard breathing is heard, dry wheezing in all fields, prolonged exhalation.

In the treatment of such patients, antibacterial drugs are used, expectorants, inhalations of berodual, salbutamol, inhaled glucocorticosteroids. Often, such patients are assigned oral glucocorticosteroids.

Physiotherapy, hardening, physiotherapy play a big role in the treatment of respiratory diseases.

Older people should be protected from drafts, but the premise in which elderly patients are kept should be well ventilated and must be wet-cleaned regularly. Such patients should walk more often - it takes 30-40 minutes a day to be outdoors.

Diabetes mellitus is a disease characterized by impaired glucose uptake by the cells, resulting in progressive lesions of large and small vessels. Isolate type I and type II diabetes, for people of advanced age is characterized by type II diabetes mellitus. Diabetes mellitus type II arises as a result of exposure to the body of many factors, among which are smoking, alcoholism, severe stress.

In patients with diabetes mellitus, genital itching appears, they are thirsty, they start to take a lot of fluids, polydipsia also arises( patients eat a lot), polyuria( the patients excrete a lot of urine).However, in elderly patients, not all of these symptoms are pronounced. The exact diagnostic criteria for the development of diabetes mellitus in a patient are the detection of high blood glucose levels( above 6.0 mmol / L) in a biochemical blood test and in the study of the glycemic profile, as well as the presence of sugar in the general urinalysis.

In the treatment of diabetes, it is very important to follow a diet that excludes sugar, foods containing carbohydrates. Patients are recommended to use sugar substitutes - saccharin and aspartame. It is necessary to regularly check blood glucose in the clinic or at home.

Patients are prescribed hypoglycemic drugs: glibenclamide, mannil. In severe cases, when the correction of blood sugar levels with sugar-reducing drugs is not possible, insulin administration is prescribed in the course of operations.

The presence of an elderly patient with diabetes always complicates the course of coronary heart disease, arterial hypertension. Since small and large vessels are affected in diabetes mellitus, the sensitivity in such patients is reduced, and the clinic of many diseases is not so typical, more blurred. For example, myocardial infarction in such patients can occur with a less intense pain syndrome. This can lead to untimely provision of medical care and death of the patient.

Diabetes can develop a hypoglycemic condition that can lead to coma, and a hyperglycemic coma.

With hypoglycemia, the patient has a feeling of anxiety, a shiver throughout the body, a feeling of hunger. He becomes covered with a cold sweat, there is weakness, confusion. In this condition, the patient needs to give a piece of sugar under the tongue, this will improve his state of health. In the hyperglycemic state, the level of glycemia is corrected by the careful administration of insulin under the control of blood sugar.

With prolonged course of diabetes mellitus, patients develop lower limb vessels - diabetic angiopathy of the lower limbs. This disease leads first to a cold snap of the feet and shins, the appearance of a feeling of numbness of the limbs, there is pain in walking, which passes, it costs a person to stop( "intermittent claudication").In the future, the sensitivity of the skin of the lower extremities decreases, pain appears at rest, ulcers and necrosis on the legs and feet occur. In the absence of treatment, the ischemic lesion of the lower limb results in amputation of the leg.

The defeat of small vessels that nourish the nerve endings, leads to a loss of sensation of the skin of the legs, a violation of its nutrition, a "diabetic foot" develops. At the same time, the patient does not feel pain from small wounds, scuffs on the skin, which turn into long-lasting non-healing ulcers. In combination with or without ischemia of the lower extremities, the "diabetic foot" can cause amputation.

For the treatment of diabetic feet, use is made of hydrofluoric acid, vasoprostane.

You also need proper foot care. Every day, wash your feet with warm water and soap, wear warm cotton socks without gum. Legs should be protected from hypothermia, wear comfortable, soft, non-ordinary footwear, carefully observe safety when cutting nails, instruct her partner or carer, treat the nail bed with iodine solution. When rubbing, you need to use a variety of creams.

Chronic pyelonephritis is a nonspecific infectious kidney disease that affects the renal parenchyma. The onset of the disease in old age is facilitated by the presence of urolithiasis, prostate adenoma, diabetes mellitus, and non-observance of genital hygiene. The disease lasts for a long time, with periods of remission and exacerbation. In the period of exacerbation there are low-grade fever, dull aching pain in the lumbar region, frequent painful urination. In elderly patients, the disease can occur without a pronounced temperature, sometimes there are changes in the psyche - anger, irritability.

In the treatment of pyelonephritis, antibacterial drugs, uroseptics, and collections of kidney herbs are used. Such patients should avoid hypothermia, observe personal hygiene.

Chronic renal failure occurs as a result of a prolonged course of chronic diseases of the urinary system( pyelonephritis, glomerulonephritis, prostate adenoma), diabetes mellitus, hypertension, or as a result of body aging( sclerotic changes occur in the kidney vessels).

This disease is characterized by the replacement of nephrons with a connective tissue, as a result of which the kidneys can no longer function adequately, their functions progressively deteriorate.

At the onset of the disease, patients have weakness, polyuria, nocturia, anemia can be detected. For a long time, the only symptom of chronic kidney failure may be a persistent increase in blood pressure figures.

Diagnosis of the disease in a biochemical blood test, which reveals an elevated level of urea and creatinine, in the study of urine, where the presence of protein, a decrease in the relative density of urine.

In the presence of patients with arterial hypertension, diabetes mellitus without adequate treatment, the infectious process, chronic renal failure begins to progress quite rapidly. Patients appear severe weakness, nausea, vomiting, intolerable skin itching, sleep disturbed. There is a significant decrease in excreted urine, hyperhydration develops, anemia, azotemia, hyperkalemia increase. Patients have symptoms of heart failure: dyspnea, tachycardia. Patients have a characteristic appearance: the skin is yellowish-pale, dry, with traces of scratching, marked swelling. Further progression of the disease can lead to the development of uremic coma.

In the treatment of chronic renal failure, hemodialysis is used on the "artificial kidney" apparatus. However, this method of treatment is quite expensive, elderly patients are severely affected by hemodialysis. Therefore, at the present time for the elderly and senile patients the methods of conservative treatment are most often used. First of all, it is necessary to treat those diseases that can lead to the development of chronic kidney failure: arterial hypertension, diabetes mellitus, chronic pyelonephritis, prostate adenoma. Very important is the early detection of these diseases and their adequate treatment. Such patients should be observed in the polyclinic at the place of residence, regularly undergo an examination to correct therapy.

To reduce the progression of renal failure, ACE inhibitors( enalapril, captopril, fosinopril), antiaggregants( hydrofluoric), sorbents( enterosgel, polyphepan) are used. Also in the treatment apply ketoanalogy of amino acids( ketosteril) to 8-12 tablets a day, activated charcoal to 10 g per day or enterodesis 5-10 g per day. It is important to observe a diet with restriction of table salt and protein( reduces consumption of meat and fish), with a sufficient amount of liquid under the mandatory control of diuresis and carbohydrates. All this makes it possible to improve the patient's quality of life, and often prolong the life of the patient for several years.

Cholecystitis chronic is an inflammatory disease of the gallbladder wall. At the same time, the ability of the gallbladder to break down and release the bile necessary for normal digestion is impaired. As a result of this, gallstones can form in the lumen of the gallbladder - cholelithiasis. The causes of cholecystitis can be: bacterial infections, viruses, possible toxic or allergic nature, sometimes - malnutrition.

The disease occurs with periods of remission and exacerbation, expressed by the presence of pain in the right hypochondrium after physical exertion, inaccuracies in the diet( eating roast, salted, smoked), nausea, a feeling of bitterness in the mouth. When clogging the bile ducts with a stone there are sharp paroxysmal pains in the right hypochondrium as a type of hepatic colic, jaundice of the skin and mucous membranes may appear - in this case, surgical treatment is necessary.

In the treatment of uncomplicated cholecystitis used antibacterial drugs, antispasmodics, cholinolytic drugs. You should also follow a diet with the exception of alcohol, fried, fatty, salty, spicy foods.

Prostate adenoma is a benign neoplasm of the prostate. Occurs in men over 50, the underlying cause of the disease is the age-related changes in the hormonal background, resulting in proliferation of prostate tissue with impaired emptying of the bladder.

Patients complain of frequent urination in small portions, urination at night, later urinary incontinence may occur.

Previously, only surgical treatment of the disease was practiced. Currently, there are drugs that allow you to reduce the size of the prostate without surgery. The most widely used are dalphase, omniks - these drugs reduce the spasm of the urinary tract and in this way eliminate the main signs of the disease. When they are used, there may be a drop in blood pressure, so they are not recommended or taken in small doses at low blood pressure values.

Deforming osteoarthritis is a group of joint diseases. It is caused by the defeat of articular cartilage, its thinning, growth of bone tissue, pains in the affected joint. Factors contributing to the occurrence of deforming osteoarthritis in the elderly are obesity, occupational stress on the joint, endocrine disorders.

The disease progresses gradually. Initially, patients experience rapid muscle fatigue and joint pain after exercise, a slight crunch in the joints during movement, a slight morning stiffness. With the progression of the disease, the symptoms become more pronounced, the limitation of movement in the joint increases, joint deformation and muscle atrophy appear. The joints of the spine, lower extremities, interphalangeal joints are most often affected. In the area of ​​distal interphalangeal joints, dense formations appear, the joint is deforming( Geberden's nodules), the joint increases in volume, assumes a spindle-shaped shape( Bushar's nodules).When the spinal column suffers, local soreness appears with the phenomena of radiculitis, stiffness.

In the treatment use therapeutic gymnastics, massage, diet for body mass correction. To stop the pain, non-steroidal anti-inflammatory drugs are used: naize, movalis, diclofenac. Also in the joint are introduced kenalog and hydrocortisone.

Physiotherapy is widely used.