I’ts summer time.  With recreation and fun can also bring sunburn or sun poisoning.   What are symptoms of sunburn?

 Some of the immediate symptoms  of sunburn after exposure are the following:

First, the skin becomes red, tender and hot.

Touching or rubbing the skin causes pain.

Heat triggers fluid loss, a sunburn victim can also become dehydrated.

Several days after exposure, the skin may swell, blister, and peel. Some sufferers develop welts or rashes.

 More subtle exposures to the sun may not have any obvious immediate symptoms such as the ones listed above. People who have chronic exposure to sun can increase their chances of developing chronic skin damage from sun exposure( scarring wrinkles, skin cancer, freckles, aging etc.). 

The symptoms of sunburn can be mild, moderate or severe depending mainly on the following:

    1. The skin type of the person affected. ( fair, medium or dark)

    2. The time, duration, location and altitude of exposure.

    3Medications the person has been taking ( sun -sensitizing drugs that may increase a person’s susceptibility to sunburn).

    4. Skin preparations (sunscreen) pt has been using.

What are the symptoms of severe sunburn ( sun poisoning)?

In severe cases the person may expeirence:

    1. fever

    2. nausea

    3. chills

    4. dizziness

    5. rapid pulse

    6. rapid breathing

    7. dehydration

    8. shock with loss of consciousness, and/or

    9. severe blisters, soreness

These symptoms require emergency medical evaluation and treatment immediatley.

What first-aid measures should be taken with sunburn?

If symptoms of severe sunburn are present, the individual should contact their primary health care practitioner, urgent care facility or Emergency Room. While waiting for treatment, the affected person should NOT drink cold water, which can trigger chills. If compresses are applied, they should be dipped in cool or tepid water, NOT cold water.

If the symptoms are mild or moderate, the person  may drink plenty of water to replenish the fluid lost from the sunburn and to avoid dehydration. Those affected may then do any or all of the following.:

    1. Apply dampened cloths or compresses to reduce the heat and lessen the pain.

    2. Soak in a bathtub of plain, soap-free water (soap can irritate the burn)

    3. Gently pat the skin dry afterwrd-DO NOT rub it

    4. Apply a soothing cream, lotion, or another preparation approved by a healthcare provider or pharmacist

           Some preparations that contain benzocaine can trigger an allergic reaction in some individuals, and certain ointments

            can retard healing by sealing off the skin from the air.

   5. If blistering occurs, apply a bandage to prevent infection

   6. If  discomfort is significant, take acetaminophen or ibuprofen.

   7. Moisturizing measures with creams or Aloe Vera gel may also help with symptoms of sunburn.

Is a follow-up visit with a physician necessary?

A follow-up visit is only necessary if the sunburn was severe or sun poisoning. But every patient who has suffered a significant sunburn should report the incident to his or her provider so that the burn can become part of the patient’s medical history. Doing so will alert the provider, during future check-ups , to look closely for symptoms of skin cancer an other problems that sunburn can cause.

Having diarrhea is no fun as it is commonly associated with the feeling of discomfort and embarrassment.  But nearly everybody gets it once in a while and it is usually caused by gastrointestinal (GI) infections.  Symtoms of GI infections include nausea, vomiting, diarrhea, loss of appetite and often times fever as well. 

Which germs are responsible for this infection depends on the geographic area a person lives in and its level of sanitation, economic development and hygiene standards.  In developed countries like the United States, outbreak of diarrhea are often caused by food poisoning.  Food poisoning happens when certain toxins made by bacteria in food that is not handled, stored, or cooked properly make a person sick. 

When a GI infection is caused by a virus, as is the case in most cases, it is called Viral Gastroenteritis.  There are many viruses that can cause diarrheal illness.  Viral Gastroenteritis can pass through a household quickly because it is highly contagious.  Fortunately, it typically resolves on its own in a few days.  For healthy adults, it is a common but minor inconvenience.  But for small children and people with chronic illnesses such as Diabetes and High Blood Pressure, it can lead to dehydration that requires urgent medical attention.

The incubation period for viral infections can range from 4 to 48 hours. These infections are highly contagious and can spread from person to person via dirty hands, contaminated food or water and sometimes pets. Most cases are contagious for as long as a person has diarrhea, but sometimes the infections can be contagious for even longer.  The most effective way to prevent them is to wash your hands frequently.

Sometimes despite our best efforts, it is impossible to prevent GI infections.  The most important, initial treatment for them is to drink adequate amount of fluids and prevent dehydration.  If you feel very tired and lethargic, your skin feels dry, or if you notice blood in the stool, you should seek medical attention right away.  You should also see a medical provider if you are unable to keep fluids down due to vomiting or if your symptoms last for more than 3 days.

(Source:  Journal of American Family Physician)

Allergic Rhinitis

Throughout the year most of us suffer from some form of runny or stuffed up nose.  Have you ever asked yourself, is this seasonal allergies or am I developing a sinus infection?  Have you ever wondered if you are in need of an antibiotic or will an antihistamine or nasal steroid spray do the trick?   Hopefully this blog will help you understand the difference between these two common medical ailments.

Allergic rhinitis is either seasonal (often occurring during a certain time of the year) or perennial (occurring year round). 

Each season brings different allergens:

In spring:  Trees like elm, maple, birch, ash, sycamore and oak

Late spring/summer:  Grass pollens and some weeds

Fall:  Most weeds including ragweed

Winter, as well as year round:  Molds

Any of these allergens, when they come in contact with our nasal mucosa, are possible culprits to elicit an allergic response to those unfortunate sufferers.  Basophils, a particular type of white blood cell in our bodies, release histamines which give us our symptoms of allergies such as repetitive sneezing, itchy eyes, ears, nose, throat, runny nose, fatigue; watering eyes, post nasal drip, impaired smell, sinus headaches and ear plugging.

Treatment for allergic rhinitis:

·         Avoidance of the allergen

·         Antihistamines and decongestants

·         Nasal sprays: steroid sprays or saline solutions

·         Allergy shots

·         Note: that antibiotics will not treat allergies

Skin testing by an allergist is the best way to confirm allergic rhinitis.

Sinusitis

Sinusitis is Infection or inflammation of the sinuses, which are cavities within our skull that are lined with the same mucosa as our nasal passages.  There are 4 pairs of sinuses in the head.  The same allergens that affect our nasal mucosa also can cause inflammation within our sinuses.   However, the most common cause of sinusitis is typically due to a virus.  The difficulty comes when the mucosa becomes so congested and inflamed that the sinuses become blocked over a long period of time.  Bacteria that are present in our upper respiratory tract can cause a secondary infection when the sinuses are unable to drain properly. 

Typically your provider can diagnose sinusitis when the following symptoms are present:

·        Allergy or viral symptoms that generally improve & then worsen with unilateral (one sided) pain

·        Increasing of sinus pressure or pain with leaning forward

·        Thick green or yellow nasal discharge

·        Maxillary tooth pain

·        Poor response to antihistamines or decongestants

·        Fever

·        Bad breath

Treatment for acute sinusitis include

·         Decongestants (over the counter)

·         Nasal rinses (over the counter)

·         Nasal vasoconstrictors:   Neosynephrine/Afrin (over the counter)

·         Nasal steroid sprays

·         Steroid injections and/or tapering steroid packs

·         Antibiotics: Typically started if symptoms have persisted for 10 days or greater

What causes the rash?

Poison ivy is a common cause of contact dermatitis, an allergic reaction to something that comes in direct contact with the skin. This condition can be quite unpleasant but does not pose serious health risks. Prevention is better than treatment but can be hard to achieve.

Poison ivy is one of many plants that produce a resin called an urushiol that can cause an allergic rash. Related plants include the familiar poison oak and sumac, which are found in different geographical distributions. (Poison ivy is more common in the eastern U.S. and poison oak in the Southeast.) The rashes that each of these plants produce have a similar appearance. In addition, the same urushiols are also found in the mango, cashew, and gingko trees. In the case of mangos, peeling the fruit prevents dermatitis. People who press the whole fruit, including the rind, against their skin can develop a severe reaction around the mouth. Those downwind from burning vegetation containing one of the offending plants can also develop widespread allergic reactions.

Identifying poison ivy

Although it is often recommended that people learn to recognize the poison ivy plant (”Leaves of three, leave them be”), in practice, this is hard to do, since poison ivy and its relatives are often mixed in with other vegetation and not noticed until after the rash has begun. Keeping the skin covered in situations in which exposure is hard to avoid is the best way to prevent the problem. More than half the population can react to the poison ivy resin if they are exposed to it.

What are the signs and symptoms of the poison ivy rash?

The poison ivy rash usually starts one or two days after exposure, though the delay between contact and its onset can be longer, up to several days. This may lead to confusion over where the exposure took place. The first signs of the rash are curved lines of red, itchy bumps or blisters. These continue to appear for many days, depending on how much resin touched the skin at a given point. This makes it seem as though the rash is “spreading,” although the fluid in blisters is just part of the allergic reaction and contains no chemicals or bacteria. It also makes it appear that there may still be poison ivy in clothes and/or on pets. Although this is theoretically possible, repeated washing of these often produces no improvement.

Poison ivy is not contagious, neither from one person to someone else nor from one part of the body to another.

Many references emphasize that animals can carry the poison ivy resin. There’s no doubt this is true, but its practical significance may be limited. The first sign of poison ivy, after all, is usually a curved line of rash on the skin. Unless your dog is shaped like a curved line, your poison ivy is more likely to have come from a stem or leaf which dragged against the skin, not from your pet.

What is the treatment for poisoning from these plants?

The best approach to poison ivy dermatitis is prevention. Washing with soap and water can help reduce the severity of the rash, but this is often impractical because it has to be done at once. (After 10 minutes, only 50% of the resin is removable, and by 30 minutes only 10%.)

Once it begins, the rash will usually clear on its own by 14-21 days. Treatment is directed at controlling the itching. Oral antihistamines (like diphenhydramine [Benadryl]) may help the itch somewhat, but often they do no more than make people drowsy. Cortisone creams, whether over-the-counter or by prescription, are only helpful if applied right away, before blisters appear, or much later, when the blisters have dried up. Compresses with cool water or Burow’s solution (available without prescription) can help dry the ooze faster.

When the rash is severe, such as when it affects the face or causes extensive blistering, oral steroids (for example, prednisone) can help produce rapid improvement. This course of therapy should be maintained, often in decreasing doses, for 10-14 days or even longer in some cases, to prevent having the rash rebound and become severe again. Patients who are given a six-day pack of cortisone pills often get worse again when they complete it, because the dose was too low and administered for too short a time.

Folklore, medical and otherwise, endorses many other agents, from aloe leaves to tea bags to meat tenderizer as treatments for poison ivy and related plant poisonings. Though these remedies are generally harmless, they are of questionable value

How can contact with these plants be prevented?

Poison ivy and its relatives are often hidden among other vegetation. Even if you know exactly what they look like, it is very hard to avoid coming in contact with them. Although wearing long pants and long sleeves in warm weather may be uncomfortable, it is important to do so when you might be in contact with plants you can’t see, whether you are gardening in the backyard or hiking in the woods. So-called “barrier creams” may help a bit but are not very effective.

When pulling up weeds, those who may be allergic should make sure to tuck sleeves into gloves at all times, since sleeves tend to ride up the forearms and leave wrists and forearms exposed.

If you think you may have been exposed to poison ivy, wash the skin with cool water as soon as possible. After half an hour, however, this is no longer likely to prevent the reaction. As discussed above, washing pets and clothing may also be of limited help.

Attempts to desensitize people by giving them poison ivy by mouth or by injection were tried in the past but proved to be ineffective and potentially dangerous

Getting a nosebleed or seeing a child get one can be dramatic and scary. Nosebleeds (whose technical term is “epistaxis”) are very common. They are usually caused by dry air or nose-picking.If you or your child gets a nosebleed, the important thing is to know how to manage it properly. With the right self-care, most nosebleeds will stop on their own. WHEN TO SEEK HELPThere are two main types of nosebleed, and one can be more serious than the other:Anterior nosebleeds originate toward the front of the nose and cause blood to flow out through the nostrils. This is the most common type of nosebleed and it is not usually serious. Posterior nosebleeds originate toward the back of the nose, near the throat. Posterior nosebleeds are less common than anterior nosebleeds, but they can be serious and can cause a lot of blood loss. Children do not usually get posterior nosebleeds.You should seek emergency medical care if your nosebleed:1.Involves massive bleeding or makes it hard to breathe 2.Causes you to become extremely pale, fatigued, or disoriented 3.Will not stop even after trying the self-care steps outlined below 4.Happens after recent nasal surgery or if you have a known nasal tumor 5.Occurs with other serious symptoms, such as chest pain 6.Occurs after an injury, such as being hit in the face, and you are concerned that you could have other injuries (eg, broken bone) 7.Will not stop bleeding and you take medications that prevent clotting, such as warfarin (Coumadin®), clopidogrel (Plavix®), or daily aspirin

 NOSEBLEED SELF-CAREWith the right self-care, most nosebleeds will stop on their own. Here’s what you should do if you get one:1. Sit or stand while bending forward slightly at the waist. Do not lie down or tilt your head back. This may cause you to swallow blood and can lead to vomiting and other uncomfortable symptoms.2. Grip the soft part of BOTH nostrils at the bottom of your nose. Do not grip the bridge of your nose, as that will not help the bleeding, and do not apply pressure to just one side, even if the bleeding is only on one side.3. Squeeze your nose closed for at least 5 minutes (for children) or 10 to 15 minutes (for adults), and use a clock to time yourself. Do not release the pressure every so often to check whether the bleeding has stopped. Many people hurt their chances of stopping the bleeding by releasing the pressure too soon or too often.4. If you want, you can also apply a cold compress or ice pack to the bridge of your nose. This can help the blood vessels constrict and slow the bleeding. This step is not usually necessary, but many people like to do it.Apply pressure for a total of at least 30 minutes. If you continue to bleed even then, seek emergency medical care, either at an emergency room or at an urgent care clinic.What if I get repeated nosebleeds? — Frequent nosebleeds can be caused by:Constant exposure to dry air Consistent use of nasal sprays (such as those used to manage allergies or congestion) Recurring colds Snorting drugs into your nose, such as cocaineIn some cases, recurring nosebleeds can be a sign of a bleeding disorder. But when bleeding disorders are at play, there are often other clues. For example, people with bleeding disorders tend to bruise easily and may bleed more than expected after minor injuries.NOSEBLEED TREATMENTIf you wind up needing medical care for a nosebleed, your healthcare provider will focus first on making sure you can breathe properly and on getting the bleeding to stop. If you have lost a lot of blood, you may need IV fluids to restore the lost blood.If the bleeding will not stop and the healthcare provider can see the source of the bleeding, he or she may stop the bleeding using a chemical or an electrical device. In severe cases, healthcare providers can pack the nostrils with tampons, gauze, foam, or other materials that can help stop the bleeding. People with serious nosebleeds may need to have a balloon inflated deep within their nose to get the bleeding to stop.A healthcare provider can also check the nose for growths or tumors or for blood vessel abnormalities. A growth or tumor may be more likely if only one nostril bleeds repeatedly or if the blood is tinged with an odorous discharge. Another explanation for one-sided bleeding or odorous discharge is the presence of a foreign body. When examining children with unexplained nosebleeds, healthcare providers often find beads, rubber erasers. NOSEBLEED PREVENTIONIf you get nosebleeds frequently, the following measures may help reduce the chances of getting a nosebleed:·         Use a humidifier in your bedroom while sleeping, especially when the air is very dry ·         Keep your nose moist using a saline nasal spray or gel ·         Avoid picking your nose, or — if you must do it — clip your fingernails to avoid injury 

CHOLESTEROL

Is cholesterol really such a big deal? Approximately 1 in 6 Americans have high cholesterol, otherwise known as hyperlipidemia or hypercholesterolemia. Cholesterol is a waxy, fat-like substance which is needed for multiple functions in the body, but is a major risk factor for heart disease and stroke when abnormally elevated.

So what does all this talk about cholesterol mean? Cholesterol is typically divided into three categories, LDL, HDL and triglycerides. LDL, low-density lipoprotein, is generally considered “bad cholesterol.” When too much LDL circulates in the blood it slowly builds up in artery walls that supply the heart and brain. This leads to plaque formation in arteries, which is referred to as atherosclerosis. If a clot forms nears these plaques blood flow to the heart muscles can be blocked and cause a heart attack, or MI. Similarly, a clot can block blood flow to the brain and cause a stroke. HDL, high-density lipoprotein, is concerned “good cholesterol.” HDL appears to carry cholesterol away from the arteries and back to the liver. A higher HDL level actually protects the heart.

So how do we get all this cholesterol? While our bodies produce cholesterol, we also take in cholesterol through our diet. Food from animals, such as egg yolks, meat, milk and dairy products add cholesterol to our diet. Saturated fatty acids from processed foods also contribute to raising cholesterol. Fruits, vegetables, grains and seeds do not contribute to bad cholesterol levels. While diet makes up the greatest controllable risk factor, obesity, inactivity and smoking also negatively affect cholesterol. Some risk factors for increased cholesterol can not be helped, such as age, sex and heredity. Men typically have higher cholesterol levels but both sexes have increased risks for elevated levels as we age.

Will I know if I have high cholesterol? No, elevated cholesterol levels do not have symptoms, which is why it is very important to see you PCP yearly for cholesterol screening. A simple blood test taken in the office and then sent to a lab for further analysis. To get a true reading you need to come in fasting (meaning you can’t eat or drink anything other than water for 8 hours). Typically this works best to come in the am.

So what are my goals for my cholesterol? This can get confusing because goals are based on personal risk factors. Persons with existing cardiac disease and diabetes have the most stringent goals. People with tobacco use, hypertension and certain family history have higher goal to reach then those without risk factors. Cholesterol goals can best be understood by meeting with your pcp to discuss your health and lifestyles, which will determine which category you should be in.

Generally speaking in low risk factor groups your cholesterol should be as follows:

Total cholesterol Less than 200 mg/dL

LDL “bad” Less than 100mg/dL

HDL “good” 40 mg/dL or higher

Triglycerides Less than 150 mg/dL

These numbers to do not apply to high risk groups.

Now that I know I have high cholesterol, how do I treat it? First are therapeutic lifestyle changes. Regular exercise will lower the bad LDL and actually raise the good HDL. Increasing your omega3 intake through fish or supplements will also help raise your HDL.

For more information on what you can do yourself, turn to the CDC website which has sites on nutrition, physical activity and obesity

http://www.cdc.gov/nutrition/everyone/basics/fat/saturatedfat.html

‘

Maintain a healthy weigh

http://www.cdc.gov/healthyweight/index.html

Exercise regularily

http://www.cdc.gov/physicalactivity/index.htnl

Don’t smoke

http://www.cdc.gov/tobacco

Sometimes, even with the best efforts, medication is needed to lower cholesterol to goal. There are several different classes of medications used to lower cholesterol and sometimes different medications have to be tried before the goal is reached. Our clinic also has Walk-in Weight loss program which can help get cholesterol to goal.

  If you’ve always believed that you can detect a fever by touching someone’s forehead, then think again. The abdomen is actually more likely to feel warm when someone has a fever. However, a thermoneter is the only way to accurately measure body temperature.      Here are six other  common–and potentially dangerous–myths regarding fever…      Myth1:  All adults have a normal body temperature of 98.6 F.   “Normal” can be between 98 and 99.4 and fluctuates during the day.  “Normal” temperature tends to decline with age,the average oral temperature of people 65 and older is 97.5F  Some older adults may be seriously ill–even with pneumonia or a widespread infection–yet appear to have no fever at all.       Myth 2.      A fever always means you have   an infection. Not necessarily.  Fever may also occur in many viral illnesses, such as influenza, gastroenteritis(stomach flu) even the common cold. But a fever can also signal an allergic reaction..dehydration..inflammation..a hormone disorder like hyperthyroidism or rheumatoid arthritis.  Some medications such as antibiotics, narcotics, barbiturates and antihistamines can trigger a fever.                                                                         Myth 3.  Fever should always be treated.    Most of the time it isn’t necessary to do anything to reduce the fever. Unless it goes quite high (above 104F in an adult) it causes no permanent damage–but you will be uncomfortable. Be sure to drink plenty of fluids to prevent dehydration. Even if your not thirsty take sips of water and juice often,  eat  soups, jello and popsicles.                                                                                                                                                                                                Myth4.                                                                                                                                                                                                                                                                                                                                                 Myth 4.  Aspirin is the best medicine for a fever.   The most common fever reducers ar acetaminophen(Tylenol), aspirin and nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen. Neither drug works faster or better than the others in reducing fever.   Use these drugs with caution! Never exceed dosage recommendations without first discussing it with your provider.   NEVER give aspirin to anyone under the age 15-it can cause Reye’s syndrome, a potentially life-threatening condition that causes swelling of the brain and the degeneration of the liver.    If you have the following conditions take acetaminophen; asthma, high blood pressure, kidney disease gastrointestinal  problems, or take daily apirin therapy.       If you have liver disease or drink more than three alcoholic beverages daily : take aspirin or another NSAID like ibuprofen or  naproxen.                                                                                                                                              Myth5. A fever means you,re contagious.  Not so. A person with an upper respiratory tract infection may be contagious early on, when he/she has a runny nose but no fever. On the other hand, a person can still be running a fever after several days of antibiotic treatment but no longer be contagious.                                                                                                                    Myth6.   All thermometers are equally accurate. Glass mercury thermometers are the most accurate but are no longer used because of potential exposure to mercuty if the glass breaks. Digital oral and digital rectal thermometers are both accurate. Ear thermometers are sligjhtly less accurate. Forehead thermometers ( plastic strips that are pressed against the forehead) are not reliable for exact measurements.  Be  sure to tell your provider which type of thermometer you used to take your temperature.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

Urinary tract infection (UTI) is one of the most common infections encountered by physicians in the primary and urgent care offices.  Most UTIs are bacterial in origin, with E. Coli being the most common cause.  The urinary tract includes the kidneys, ureters and bladder.  Women tend be affected by UTI much more often than men.

Common signs and symptoms of UTI include burning sensation with urination, urgency to urinate with increased frequency, and discolored or smelly urine.  However, sometimes its symptoms may be non-specific, such as fever, low back pain and nausea.

If your family doctor thinks you have a UTI, he or she will probably test a sample of your urine to see if it contains bacteria, glucose or blood.  If the test is positive, your doctor will prescribe an antiobiotic for a few days to effectively treat a UTI. Make sure you finish the entire course of the antibiotic as prescribed even if your symptoms improve in 1-2 days. Your doctor may also suggest a medicine to numb your urinary tract and make you feel better while the antibiotic starts to work. The medicine makes your urine turn bright orange, so don’t be alarmed by the color when you urinate.

Even though most UTIs are effectively treated with the antibiotics, a history of frequent UTIs warrants further evaluation and advanced testing as appropriate.  There are some simple and easy steps that can help you to prevent a UTI.  For example, do not hold your urine for a prolonged period of time when you have the urge to urinate; Wipe from front to back after bowel movements; Urinate after having sex to wash away bacteria; Use lubrication during sex; And avoid douching.

This information was written in accordance with the upcoming month of February being the American Heart Month.

Did you know that every 25 seconds, an American will have a coronary event?  That means by the time you finish reading this article, approximately 12 people will have had a heart event.  Heart disease is the leading cause of death for both men and women in the United States and a major cause of disability.  Luckily, awareness of risk factors associated with heart disease and healthy lifestyle changes can greatly reduce the risk of developing heart disease.

There are several risk factors associated with heart disease.  This is a list of a few:

• Arrhythmia  (abnormal electrical activity in the heart where the heart beat may be too fast or too slow)
• High cholesterol,
• High blood pressure
• Obesity
• Tobacco
• Second hand smoke. 

 Many of these factors can be prevented by stopping smoking, limiting your exposure to second hand smoke, and seeing your family doctor on a regular basis to monitor your blood pressure and cholesterol.  Did you know that the providers at Care United are able to monitor and manage these conditions before they become a problem?  Our staff is able to manage conditions such as high blood pressure and high cholesterol with preventative measures to help you to make the necessary lifestyle changes, as well as medications, if necessary  Speaking of lifestyle changes, there are many that can help reduce you and your family’s risk of developing heart disease.  Start slow with a few changes and as they become patterns in your day to day life, add more changes in order to prevent heart disease.  The Center for Disease Control and Prevention (CDC) recommends the following: 

• Choose lean meats and poultry without skin
• Select fat-free, 1% fat, and low-fat dairy products
• Cut back on foods containing vegetable oils and ones high in dietary cholesterol
• If you drink alcohol, drink in moderation (no more than one drink per day for a woman and two drinks per day for a man)
• Choose and prepare foods with little or no salt (try and aim for less than 2,300 mg of sodium per day or less than 1,500 if you have or at risk of high blood pressure)
• Increase the amount of physical activity in your life to at least 30 minutes of activity per day

Conjunctivitis is an inflammation in a part of your eye. The conjunctiva is a thin lining that covers the whites of the eyes and the insides of the eyelids. This lining helps protect your eyes. The conjunctiva can be irritated by chemicals, contact lenses, dry eyes, allergic reactions, or foreign bodies, such as sand, in the eyes. Most often, though, conjunctivitis is caused by a virus and goes away in a few days without any treatment.

Sometimes conjunctivitis is a sign of a more serious problem. It might be a bad infection, a rare type of cancer, swollen glands on the edge of the eyelid (called styes), or an eye problem called glaucoma. Glaucoma is caused by too much pressure inside the eyeball. Sexually transmitted diseases (such as chlamydia infection) can also cause infections in the eye, but these are rare.

Conjunctivitis sometimes can be confused with a more serious condition called iritis . If you have pain in your eye or any sudden changes in your vision, call your doctor right away. If light makes your eyes hurt, you should tell your doctor as soon as possible.

The most common signs of conjunctivitis are bloodshot or watery eyes, stinging, and burning. Itching can be a sign of allergic conjunctivitis or a sign of infection. If your conjunctivitis is caused by bacteria (germs), you might have thick, white fluid or pus coming out of your eye. If a virus has caused your infection, the fluid coming out of your eyes usually is clear.

What can I do to keep from getting conjunctivitis?

Conjunctivitis that is caused by viruses or bacteria can be spread from person to person. It is important to wash your hands with soap often during the day. Try not to touch your eyes or rub your eyes with your fingers. If you have conjunctivitis that is caused by an allergy, try to stay away from the things you are allergic to.

See your doctor before you try to treat yourself. If you have a virus, your doctor might not recommend any treatment. If you have bacterial conjunctivitis, you might need to use antibiotic eye drops. If you have allergic conjunctivitis, your doctor might want you to put cold compresses on the eye or take a non-prescription antihistamine (such as Benadryl or Chlor-Trimeton). Your doctor also might prescribe a non-drowsy oral antihistamine or antihistamine eye drops.

If you wear contact lenses, take them out until you’ve seen your doctor or until your symptoms have completely gone away.

• This handout is provided to you by your family doctor and the American Academy of Family Physicians.