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What is Diabetes?

Diabetes can strike anyone, from any walk of life.

And it does ñ in numbers that are dramatically increasing. In the last decade, the cases of people living with diabetes jumped almost 50 percent ñ to more than 30 million Americans. Worldwide, it afflicts more than 422 million people.

Diabets is a leading cause of blindness, kidney failure, amputations, heart failure and stroke.

Living with diabetes places an enormous emotional, physical and financial burden on the entire family. Annually, diabetes costs the American public more than $245 billion.

Just what is diabetes?

To answer that, you first need to understand the role of insulin in your body. When you eat, your body turns food into sugars, or glucose. At that point, your pancreas is supposed to release insulin. Insulin serves as a ìkeyî to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy.

But with diabetes, this system does not work.

Several major things can go wrong ñ causing the onset of diabetes. Type 1 and type 2 diabetes are the most common forms of the disease, but there are also other kinds, such as gestational diabetes, which occurs during pregnancy, as well as other forms.

Do you want to learn more about the basics of diabetes? Read our brochure: "What is Diabetes?" in English or "øQue es La Diabetes?" in Spanish.
What is Type 1 Diabetes?

The more severe form of diabetes is type 1, or insulin-dependent diabetes. Itís sometimes called ìjuvenileî diabetes, because type 1 diabetes usually develops in children and teenagers, though it can develop at any age.

What is diabetes? This illustration shows the pancreas and insulin, with insulin represented as the ëkeyí that ëopensí cells, allowing blood glucose to enter, and allowing body to use the glucose for energy
Immune System Attacks

With type 1 diabetes, the bodyís immune system attacks part of its own pancreas. Scientists are not sure why. But the immune system mistakenly sees the insulin-producing cells in the pancreas as foreign, and destroys them. This attack is known as "autoimmune" disease.

These cells ñ called ìisletsî (pronounced EYE-lets) ñ are the ones that sense glucose in the blood and, in response, produce the necessary amount of insulin to normalize blood sugars.

Insulin serves as a ìkeyî to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy. Without insulin, there is no ìkey.î So, the sugar stays -- and builds up-- in the blood. The result: the bodyís cells starve from the lack of glucose. And, if left untreated, the high level of ìblood sugarî can damage eyes, kidneys, nerves, and the heart, and can also lead to coma and death.
Insulin Therapy

So, a person with type 1 treats the disease by taking insulin injections. This outside source of insulin now serves as the ìkeyî -- bringing glucose to the bodyís cells.

The challenge with this treatment is that itís often not possible to know precisely how much insulin to take. The amount is based on many factors, including:

ïFood

ïExercise

ïStress

ïEmotions and general health
Balancing Act

These factors fluctuate greatly throughout every day. So, deciding on what dose of insulin to take is a complicated balancing act.

If you take too much, then your body burns too much glucose -- and your blood sugar can drop to a dangerously low level. This is a condition called hypoglycemia, which, if untreated, can be potentially life-threatening.

If you take too little insulin, your body can again be starved of the energy it needs, and your blood sugar can rise to a dangerously high level -- a condition called hyperglycemia. This also increases the chance of long-term complications.
What is Type 2 Diabetes?

The most common form of diabetes is called type 2, or non-insulin dependent diabetes.

This is also called ìadult onsetî diabetes, since it typically develops after age 35. However, a growing number of younger people are now developing type 2 diabetes.

People with type 2 are able to produce some of their own insulin. Often, itís not enough. And sometimes, the insulin will try to serve as the ìkeyî to open the bodyís cells, to allow the glucose to enter. But the key wonít work. The cells wonít open. This is called insulin resistance.

Often, type 2 is tied to people who are overweight, with a sedentary lifestyle.

Treatment focuses on diet and exercise. If blood sugar levels are still high, oral medications are used to help the body use its own insulin more efficiently. In some cases, insulin injections are necessary.

What is type 2 diabetes

Type 2 diabetes is a chronic condition that affects your bodyís use of glucose (a type of sugar you make from the carbohydrates you eat). Glucose is the fuel your cells need to do their work. You need glucose for energy. You also need insulin, a hormone produced by the pancreas that helps glucose enter your cells so that it can be converted to energy.

Hereís the problem: People with type 2 diabetes (also known as diabetes mellitus) canít properly use or store glucose, either because their cells resist it or, in some cases, they donít make enough. Over time, glucose builds up in the bloodstream, which can lead to serious health complications unless people take steps to manage their blood sugar.

Type 2 diabetes affects more than 29 million Americans, including nearly eight million who donít even know they have it. You may be at greater risk of developing type 2 diabetes if it runs in your family, if you are of a certain age or ethnicity, or if you are inactive or overweight.

Type 2 diabetes vs. type 1 diabetes

Whatís the difference between type 1 and type 2 diabetes?

Type 1 diabetes is an autoimmune disease in which the body does not produce insulin. The immune system destroys insulin-producing cells in the pancreas. Type 1 diabetes is usually diagnosed in children, teens, and young adults. People with type 1 diabetes need life-long insulin therapy.

Type 2 diabetes is much more common. In type 2 diabetes, the body doesnít use insulin properly or, in some cases, doesnít make enough. Itís usually diagnosed in middle-aged or older adults, but anyone can develop type 2 diabetes. It can be managed through diet, exercise, and medication.

RELATED: The Best and Worst Foods for People With Diabetes

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What causes type 2 diabetes?

Type 2 diabetes occurs when the body doesnít use insulin as it should or when the pancreas doesnít make enough insulin to ferry glucose out of the bloodstream and into the cells. Instead, the glucose builds up in the blood, resulting in high blood sugar.

When your body canít use insulin properly, itís called insulin resistance. Insulin resistance is responsible for most cases of type 2 diabetes. Scientists donít know why cells in the body become resistant to insulin, but itís clear that certain genetic and lifestyle factors play a role. Here are the most common:

Your genes. Type 2 diabetes tends to run in families. Scientists havenít pinpointed the gene or genes responsible for insulin resistance. But even if you inherit certain genes that amp up your risk, it doesnít mean you will go on to develop type 2 diabetes. How you live your life also affects your risk.
Your race. Certain racial groups, especially African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders have a higher risk of developing type 2 diabetes than white people.
Your lifestyle. Thereís nothing you can do about the genes you inherit. But you can control how you live. Being overweight is the main risk factor for developing insulin resistance, especially if you carry that extra weight around your waist. Being sedentary, smoking, drinking too much alcohol, and consuming a high-fat, low-fiber, sugar-laden diet can all increase your type 2 diabetes risk. You can reduce your risk by adopting healthier habits.
Your existing health concerns. Other medical issues that can increase your risk of developing type 2 diabetes include:
Having prediabetes. Prediabetes means having higher-than-normal blood glucose levels but not high enough to be diagnosed with type 2 diabetes. People with prediabetes who donít control their blood sugar can go on to develop type 2 diabetes.
Having gestational diabetes. Women who have gestational diabetes have elevated blood sugar levels during pregnancy and are at higher risk of developing type 2 diabetes later on. Moms should be tested six to 12 weeks after giving birth to screen for the condition.
Having another condition linked to type 2 diabetes. Polycystic ovary syndrome, for example, affects womenís sex hormones and is associated with an elevated diabetes risk, as is a history of heart disease or stroke.

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Type 2 diabetes symptoms

Type 2 diabetes can sneak up on you. Many people donít know they have it because symptoms usually develop slowly over time. But there are several signs of type 2 diabetes to watch for. Early indicators include increased urination, thirst, and hunger. Over time, excess sugar in the bloodstream can lead to other symptoms, including slow-to-heal wounds and frequent infections. If you develop any of these symptoms of type 2 diabetes, talk to your doctor.

Excessive urination. Running to the bathroom more often than usual or producing more urine than normal (including at night) can be one of the first signs of type 2 diabetes. Excessive urination, also called polyuria, occurs when blood sugar levels are too high. The kidneys have to work overtime to filter the excess sugar out of your blood, and some of it gets flushed out of the body in your urine.
Increased thirst. Excessive thirst, also called polydipsia, is another classic sign of type 2 diabetes. When your blood glucose is higher than normal, excess sugar spills into your urine, pulling water with it, and you have to urinate more frequently. You can become dehydrated from all that extra urination, so you then become thirsty, leading you to drink even moreñand urinate more.
Increased hunger. When you are insulin resistant or donít make enough insulin, glucose canít enter your cells. Starved for energy, you get hungrier than usual. Excessive hunger or increased appetite is also known as polyphagia.
Blurred vision. High blood sugar can cause the lens of the eye to swell, causing blurry vision. If your blood sugar levels fluctuate, you may notice at least a temporary improvement when sugar levels are closer to normal.
Unexplained weight loss. Sudden or unplanned weight loss can be a sign that your cells arenít getting glucose for energy. Without that sugar for fuel, your body begins burning fat and muscle instead, leading to weight loss.
Fatigue. When blood sugar is elevated, that fuel canít get to its destination. As a result, your energy lags, and you feel depleted. You may not be sleeping well, either, if you make frequent nighttime trips to the bathroom to empty your bladder.
Frequent infections. Yeast and bacteria thrive on sugar, so when blood glucose levels are abnormally high, thereís a greater risk for frequent or more severe yeast or urinary tract infections.
Slow-healing wounds. People with type 2 diabetes may find that it takes a long time for skin injuries to heal. Thatís because sugary blood is thicker and moves more slowly, especially through narrow blood vessels, meaning healing blood and oxygen takes longer to reach damaged tissue. Having open sores and wounds also boosts the risk for infections.
Dry, itchy skin. Everyone gets dry skin, but itchy feet, ankles, or legs could be signs of type 2 diabetes if you have other symptoms too. Fluid loss due to frequent urination plus poor circulation and nerve damage due to thick, sugary blood can dry out your skin, especially on your lower extremities.

RELATED: Have Diabetes? 7 Tips for a Healthy Pregnancy

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How is diabetes diagnosed?

Several tests may be used for diagnosing diabetes. A simple blood test known as a hemoglobin A1C (or glycated hemoglobin test) measures average blood glucose levels over the past three months. (Why three months? Because glucose attaches to a protein called hemoglobin in red blood cells, and those cells get recycled and replenished about every three months.)

A normal A1C is below 5.7%. A higher percentage reflects higher blood glucose levels. Prediabetes is defined as a reading of 5.7 to 6.4, while diabetes is diagnosed when glucose levels reach 6.5% or higher.

A fasting plasma glucose test measures blood glucose at a single point in time. Generally, this test is performed first thing in the morning before breakfast, after at least eight hours of fasting. A normal reading is less than 100 milligrams per deciliter (mg/dl). A reading of 100 to 125 mg/dl signals prediabetes, and a reading of 126 mg/dl or higher indicates diabetes.

An oral glucose tolerance test measures your bodyís ability to handle glucose. It is mostly used to diagnose gestational diabetes. First, blood is drawn after an overnight fast. Then you drink a special glucose solution, and your blood is drawn again two hours later. A normal reading at that time is 139 mg/dl or below. A reading of 140 to 199 mg/dl indicates prediabetes, while diabetes is diagnosed at 200 mg/dl or above.

A random or casual plasma glucose test may be performed any time you have diabetes symptoms. It doesnít require fasting. A reading of 200 mg/dl or above suggests diabetes.

These tests cannot distinguish between type 1 and type 2 diabetes. Generally, people with type 1 diabetes are diagnosed as children, teens, or young adults, while type 2 diabetes usually occurs in adults 45 and older. Type 1 diabetes is an autoimmune disease, so an autoantibody test may be done to help a doctor determine if you have type 1 or type 2 diabetes.

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Type 2 diabetes treatment

Type 2 diabetes is treated through diet, exercise, and medication. The goal of treatment is to keep blood sugar under control and stave off diabetes complications.

Some people manage through diet and exercise alone. Others need oral medicines, insulin, other injectable medications, or some combination of type 2 diabetes medñalong with healthy food and fitnessñto keep blood sugar in check.

There are lots of treatment options. What your doctor prescribes may depend on what other health conditions you have and how well certain medications work for you.

RELATED: 12 Myths About Insulin and Type 2 Diabetes

Diabetes treatment includes:

Metformin. This oral medication comes as a pill or liquid. Itís often the first medicine that people with type 2 diabetes take. Metformin improves your bodyís use of insulin and reduces the amount of glucose your liver makes.
Sulfonylureas. These pills stimulate the release of insulin by the pancreas and help the body use insulin better. Popular sulfonylureas include glimepiride (Amaryl), glipizide (Glucotrol), and glyburide (DiaBeta, Micronase, and Glynase).
Meglitinides. Much like sulfonylureas, this class of medicines boosts insulin production in the body. These oral meds, including repaglinide (Prandin) and nateglinide (Starlix), are fast acting and donít stay in the body for long, so they must be taken just before meals.
Thiazolidinediones. Also known as TZDs or glitazones, these oral medications work by lowering insulin resistance. This class includes pioglitazone (Actos) and rosiglitazone (Avandia).
Gliptins or DPP-4 inhibitors. This class of drugs improves the release of insulin in the body. One example is sitagliptin (Januvia).
SGLT2 inhibitors. These oral medicines help your kidneys remove sugar from the body through urine. The class includes canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin (Jardiance).
GLP-1 receptor agonists. Injectable drugs like exenatide (Byetta), liraglutide (Victoza), and dulaglutide (Trulicity) control blood sugar by slowing digestion, improving how insulin works in the body, and preventing the liver from releasing too much sugar into the bloodstream.
Insulin therapy. There are many different types of insulin. They vary by how soon they start to work, when they peak, and how long they last. Insulin comes in different strengths and has multiple delivery methodsñneedle, pen, pump, port, jet injector, and inhaler.
Bariatric surgery. Research suggests that weight-loss surgery can improve blood sugar control in some obese people with type 2 diabetes. Some people may no longer need diabetes medication after bariatric surgery, but these results tend to vary patient to patient.

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Can type 2 diabetes be cured or reversed?

No treatments can cure diabetes. But this chronic condition can be controlled, and sometimes symptoms even disappear for periods of time.

Remember, type 2 diabetes develops gradually as the cells in the body resist insulin or the pancreas fails to make enough of it. For a while, thereís enough insulin to get by. But, in time, the body can no longer convert glucose into energy, causing blood sugar levels to spike.

Type 2 diabetes treatments donít fix this problem. Thereís no type 2 diabetes cure. But medications can help people normalize their blood sugar, and gaining control over your blood sugar is crucial for preventing or reducing complications.

Left untreated, type 2 diabetes can wreak havoc, damaging the heart, blood vessels, nerves, kidneys, brain, eyes, feet, and skin. It increases the risk for heart attack and stroke. It can lead to kidney failure. People with type 2 diabetes can lose their vision. In some severe cases, people with type 2 diabetes need a foot or a leg amputated. The risk of these and other complications is why it is so important to keep your blood sugar under control.
Type 2 diabetes diet

A healthy diet can help people with type 2 diabetes shed excess weight and manage blood sugar. While thereís no one-size-fits-all meal plan for controlling type 2 diabetes, watching what and how much you eat can go a long way.

One option for your type 2 diabetes diet is to adopt a plant-based Mediterranean-style of eating, incorporating healthy oils, fish, fruits, vegetables, nuts, and beans.

Or ìCreate Your Plateî with the help of an online tool by the American Diabetes Association. Fill half of your plate with non-starchy vegetables, one quarter with protein and one quarter with grains or other starchy foods. Add a serving of fruit, dairy, or both, and use healthy fats in small amounts. Round out your meal with water or a low-calorie drink like unsweetened coffee or tea.

Some people learn to count carbohydrates, since carbs affect blood sugar more than protein and fat. Keeping track of daily carb consumption can help keep blood sugar levels within a normal range. A dietitian or diabetes counselor can help you learn to track grams of carbohydrate in the foods you eat.

RELATED: 20 Tasty Diabetes-Friendly Recipes

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Type 2 diabetes prevention

To prevent type 2 diabetes, take a close look at your health habits. Thereís a lot you can do to lower your risk, and even modest changes can help.

Eat healthy. To prevent weight gainña major risk factor for type 2 diabetesñeat more fruits and vegetables, cut back on sugary drinks and desserts, and watch your portion sizes.
Lose weight. If youíre overweight, dropping just 5% to 7% of your weight (thatís 10 to 14 pounds for a 200-pound person), and keeping that weight off, can prevent or delay type 2 diabetes.

RELATED: 10 Diet and Exercise Tricks to Control Diabetes

Get physical. The American Diabetes Association recommends a combination of aerobic exercise and strength training. Aim for 30 minutes of moderate to vigorous exercise, like brisk walking, swimming, cycling, or tennis, at least five days a week. Strength-training exercises build muscle mass, which helps you burn more calories, even when youíre at rest, so you can keep those pounds off.

Celebrities with type 2 diabetes

Actors, athletes, and musicians arenít immune to type 2 diabetes. While some famous folks with diabetes say the diagnosis came as a surprise, others were aware of risk factors they faced, like a family history of the disease. After making healthy changes, many chose to speak out about the dangers of type 2.

Actor Tom Hanks announced his type 2 diabetes diagnosis in 2013, revealing that his blood sugar levels had been high for years before he was diagnosed. Itís possible that his yo-yo dieting for rolesñhe gained 30 pounds to play Jimmy Dugan in A League of Their Own and later shed 50 to play Chuck Noland in Cast Awayñcould have increased his risk of blood sugar problems.

Celebrity chef Paula Deen, famous for dishes loaded with fat and calories, confirmed she had type 2 diabetes in 2012. A buttery diet alone will not necessarily cause diabetes, however; Deen spoke out about other risk factors that can play a role in the disease, like age, genes, and stress.

Tennis legend Billie Jean King was diagnosed with type 2 diabetes in 2007. After years of battling with her weight, she used the diagnosis as motivation to lose 35 pounds. Music producer Randy Jackson also lost weight after a type 2 diabetes diagnosis. With gastric bypass surgery, he shed almost 100 pounds and got his blood sugar under control.

Other notable stars with type 2 diabetes include self-proclaimed ìdivabeticî Patti Labelle, who was diagnosed after passing out on stage in 1994; actor Paul Sorvino, who experienced fatigue and increased thirst for months before he was diagnosed; and Dick Clark, who became a spokesperson for the American Association of Diabetes Educators 10 years after he himself was diagnosed.

What is Diabetes?

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesnít make enoughóor anyóinsulin or doesnít use insulin well. Glucose then stays in your blood and doesnít reach your cells.

Over time, having too much glucose in your blood can cause health problems. Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy.

Sometimes people call diabetes ìa touch of sugarî or ìborderline diabetes.î These terms suggest that someone doesnít really have diabetes or has a less serious case, but every case of diabetes is serious.
What are the different types of diabetes?

The most common types of diabetes are type 1, type 2, and gestational diabetes.
Type 1 diabetes

If you have type 1 diabetes, your body does not make insulin. Your immune system attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age. People with type 1 diabetes need to take insulin every day to stay alive.
Type 2 diabetes

If you have type 2 diabetes, your body does not make or use insulin well. You can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes occurs most often in middle-aged and older people. Type 2 is the most common type of diabetes.
Gestational diabetes

Gestational diabetes develops in some women when they are pregnant. Most of the time, this type of diabetes goes away after the baby is born. However, if youíve had gestational diabetes, you have a greater chance of developing type 2 diabetes later in life. Sometimes diabetes diagnosed during pregnancy is actually type 2 diabetes.
Other types of diabetes

Less common types include monogenic diabetes, which is an inherited form of diabetes, and cystic fibrosis-related diabetes .
How common is diabetes?

As of 2015, 30.3 million people in the United States, or 9.4 percent of the population, had diabetes. More than 1 in 4 of them didnít know they had the disease. Diabetes affects 1 in 4 people over the age of 65. About 90-95 percent of cases in adults are type 2 diabetes.1
Who is more likely to develop type 2 diabetes?

You are more likely to develop type 2 diabetes if you are age 45 or older, have a family history of diabetes, or are overweight. Physical inactivity, race, and certain health problems such as high blood pressure also affect your chance of developing type 2 diabetes. You are also more likely to develop type 2 diabetes if you have prediabetes or had gestational diabetes when you were pregnant. Learn more about risk factors for type 2 diabetes.
What health problems can people with diabetes develop?

Over time, high blood glucose leads to problems such as

heart disease
stroke
kidney disease
eye problems
dental disease
nerve damage
foot problems

You can take steps to lower your chances of developing these diabetes-related health problems.

How is Diabetes Treated?

The goals of diabetes treatment are to control your blood glucose levels and prevent diabetes complications. Your diabetes healthcare team will focus on these three areas to help you achieve optimum health:

Nutrition

When you have type 1 or type 2 diabetes, you need to be very aware of not only what you eat, but also when and how much you eat. A Certified Diabetes Educator (CDE) at Joslin can work with you to develop a healthy meal plan that fits your lifestyle. Following a meal plan can also help you lose weight and lower your risk of developing complications.

Physical Activity

Physical activity is an important part of controlling diabetes and preventing complications such as heart disease and high blood pressure. "We know that exercise is a very effective way to help bring blood sugars under control for someone with type 2 diabetes," says Kenneth Snow, M.D., Acting Chief, Adult Diabetes, Joslin Clinic. Try for 30 minutes of moderate exercise, like brisk walking, on most days. Joslin's Why WAIT? and Easy Start exercise programs are great resources for developing a safe weight loss program.

Medications

If you have type 2 diabetes, sometimes eating healthy and engaging in physical activity is not enough. Your doctor may give you oral medication to help control your blood glucose levels. For people with type 1 diabetes (and some people with type 2 diabetes) this means taking insulin. People with type 1 diabetes must take insulin to control diabetes--and this can only be done through multiple injections or by an insulin pump, a small device that delivers insulin continuously throughout the day. For more on medications and diabetes, click here.

How to Reverse Diabetes Naturally
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Reverse diabetes - Dr. Axe

According to the 2017 National Diabetes Statistics Report, over 30 million people living in the United States have diabetes. Thatís almost 10 percent of the U.S. population. And diabetes is the seventh leading cause of death in the United States, causing, at least in part, over 250,000 deaths in 2015. Thatís why itís so important to take steps to reverse diabetes and the diabetes epidemic in America.

Type 2 diabetes is a dangerous disease that can lead to many other health conditions when itís not managed properly, including kidney disease, blindness, leg and food amputations, nerve damage, and even death. (1)

Type 2 diabetes is a completely preventable and reversible condition, and with diet and lifestyle changes, you can greatly reduce your chances of getting the disease or reverse the condition if youíve already been diagnosed. If you are one of the millions of Americans struggling with diabetes symptoms, begin the steps to reverse diabetes naturally today. With my diabetic diet plan, suggested supplements and increased physical activity, you can quickly regain your health and reverse diabetes the natural way.
The Diabetes Epidemic

Diabetes has grown to ìepidemicî proportions, and the latest statistics revealed by the U.S. Centers for Disease Control and Prevention state that 30.3 million Americans have diabetes, including the 7.2 million people who werenít even aware of it. Diabetes is affecting people of all ages, including 132,000 children and adolescents younger than 18 years old. (2)

The prevalence of prediabetes is also on the rise, as itís estimated that almost 34 million U.S. adults were prediabetic in 2015. People with prediabetes have blood glucose levels that are above normal but below the defined threshold of diabetes. Without proper intervention, people with prediabetes are very likely to become type 2 diabetics within a decade.

Find out how I recommend you can reverse diabetes naturally in 30 days.

The cost of diabetes to our nation is a staggering $245 billion a year as of 2012. The American Diabetes Association reports that the average medical expenditure for people with diabetes was about $13,700 per year. People with diabetes typically have medical costs that are approximately 2.3 times higher than those without diabetes. (3)

Diabetes by the numbers - Dr. Axe

Aside from the financial costs of diabetes, the more frightening findings are the complications and co-existing conditions. In 2014, 7.2 million hospital discharges were reported with diabetes as a listed diagnosis. Patients with diabetes were treated for major cardiovascular diseases, ischemic heart disease, stroke, lower-extremity amputation and diabetic ketoacidosis.
The Cause of Diabetes

Diabetes is an illness related to elevated blood sugar levels. When you stop releasing and responding to normal amounts of insulin after eating foods with carbohydrates, sugar and fats, you have diabetes. Insulin, a hormone thatís broken down and transported to cells to be used as energy, is released by the pancreas to help with the storage of sugar and fats. But people with diabetes donít respond to insulin properly, which causes high blood sugar levels and diabetes symptoms.

Itís important to note that thereís a difference between type 1 and type 2 diabetes. Hereís an explanation of the two types of diabetes and what causes these conditions:

Type 1 Diabetes

Type 1 diabetes is commonly called ìjuvenile diabetesî because it tends to develop at a younger age, typically before a person turns 20 years old. Type 1 diabetes is an autoimmune disease where the immune system attacks the insulin-producing beta cells in the pancreas. The damage to the pancreatic cells leads to a reduced ability or complete inability to create insulin. Some of the common causes that trigger this autoimmune response may include a virus, genetically modified organisms, heavy metals, vaccines, or foods like wheat, cowís milk and soy. (4)

The reason foods like wheat and cowís milk have been linked to diabetes is because they contain the proteins gluten and A1 casein. These proteins can cause leaky gut, which in turn causes systemic inflammation throughout the body and over time can lead to autoimmune disease.

Type 1 diabetes is rarely reversed, but with the right dietary changes major improvements in blood sugar levels can be seen and a person can often reduce his or her dependence on insulin and medications.

Type 2 Diabetes
Type 2 diabetes is the most common form of diabetes, and unlike type 1 diabetes, it usually occurs in people over the age of 40, especially those who are overweight. Type 2 diabetes is caused by insulin resistance, which means that the hormone insulin is being released, but a person doesnít respond to it appropriately. Type 2 diabetes is a metabolic disorder thatís caused by high blood sugar. The body can keep up for a period of time by producing more insulin, but over time the insulin receptor sites burn out. Eventually, diabetes can affect nearly every system in the body, impacting your energy, digestion, weight, sleep, vision and more. (5)

There are many underlying causes of type 2 diabetes, and the disease usually develops because of a combination of factors, including: (6)

having a poor diet
being overweight
having high levels of inflammation
living a sedentary lifestyle
experiencing high amounts of stress
having a family history of diabetes (especially a parent or sibling)
having high blood pressure or a history of heart disease
having a hormonal condition (like hyperthyroidism, polycystic ovary syndrome or Cushingís syndrome)
being exposed to toxins, viruses or harmful chemicals
taking certain medications (like those that disrupt insulin production)

Thankfully, there are ways to reverse diabetes naturally.

draxe-Insulin Resistance infographic2

5-Step Plan to Reverse Diabetes
Step 1: Remove These Foods to Reverse Diabetes Naturally

Certain foods negatively affect your blood sugar levels, cause inflammation and trigger immune responses. To reverse diabetes naturally, the first step is to remove these foods from your diet:

Refined sugar: Refined sugar rapidly spikes blood glucose, and soda, fruit juice and other sugary beverages are the worst culprits. These forms of sugar enter the bloodstream rapidly and can cause extreme elevations in blood glucose. (7) Even though natural sweeteners like raw honey and maple syrup are better options, they can still affect blood sugar levels, so only use these foods on occasion. Your best option is to switch to stevia, a natural sweetener that wonít have as much of an impact.
Grains: Grains, especially gluten-containing grains like wheat, contain large amounts of carbohydrates that are broken down into sugar within only a few minutes of consumption. Gluten can cause intestinal inflammation, which affects hormones like cortisol and leptin, and can lead to spikes in blood sugar. I recommend removing all grains from your diet for 90 days as your body adjusts to this healing program. Then you can try bringing sprouted ancient grains back into your diet in small amounts.
Conventional cowís milk: Conventional cowís milk and dairy products should be eliminated, especially for people with type 1 diabetes. Dairy can be a fantastic food for balancing blood sugar if it comes from goatís, sheep or A2 cows. But stay away from all other forms of dairy because the A1 casein produced by conventional cows will harm the body and trigger an immune response similar to gluten. When buying dairy, only purchase raw and organic products from pasture-raised animals.
Alcohol: Alcohol can dangerously increase blood sugar and lead to liver toxicity. Research published in Annals of Internal Medicine found that there was a 43 percent increased incidence of diabetes associated with heavy consumption of alcohol, which is defined as three or more drinks per day. (8) Beer and sweet liquors are especially high in carbohydrates and should be avoided.
GMO foods: GMO corn, soy and canola have been linked to kidney and liver disease and may promote diabetes. I suggest removing all GMO foods and all packaged foods from your diet. Opt for products that are labeled organic or GMO-free.
Hydrogenated oils: Remove hydrogenated, rancid oils from your diet, including vegetable oil, soybean oil, cottonseed oil and canola oil. Because these oils are processed, treated at very high temperatures, and combined with bleaching agents and artificial dyes, consuming them has been linked to many health concerns, including diabetes.

Step 2: Incorporate These Foods to Treat Diabetes

To reverse or prevent type 2 diabetes, add the following foods into your diet:

Foods high in fiber: Research shows that 90 percent of the U.S. population doesnít consume enough fiber on a daily basis. High-fiber foods help slow down glucose absorption, regulate your blood sugar levels and support detoxification. Aim to eat at least 30 grams of fiber per day, which can come from vegetables (like Brussels sprouts, peas and artichokes), avocados, berries, nuts and seeds, especially chia seeds and flaxseeds. (9)
Foods high in chromium: Chromium is a nutrient thatís involved in normal carbohydrate and lipid metabolism. Foods high in chromium can improve the glucose tolerance factor in your body and naturally balance out blood glucose levels. It plays a role in insulin pathways, helping bring glucose into our cells so it can be used for bodily energy. Broccoli has the highest amounts of chromium, but you can also find it in raw cheese, green beans, brewerís yeast and grass-fed beef. (10)
Magnesium-rich foods: Magnesium can help regulate blood sugar levels because it plays a role in glucose metabolism. Research shows that diabetes is frequently associated with magnesium deficiency. Eating magnesium-rich foods, like spinach, chard, pumpkin seeds, almonds, yogurt and black beans, can improve type 2 diabetes symptoms. (11)
Healthy fats: Medium-chained fatty acids found in coconut and red palm oil can help balance blood sugar levels, and they serve as the preferred fuel source for your body rather than sugar. Using coconut milk, ghee and grass-fed butter can also help balance out your blood sugar levels, so include these foods into your meals and smoothies.
Clean protein: Eating protein foods has a minimal effect on your blood glucose levels, and it can slow down the absorption of sugar. Some of the best sources of clean protein include wild-caught fish, which contains omega-3 fats that reduce inflammation, grass-fed beef, organic chicken, lentils, eggs and bone broth.
Foods with a low glycemic load: The glycemic index of a food tells you about the blood glucose-raising potential of the food. Foods that have a high glycemic index are converted into sugar after being eaten more quickly than low glycemic foods. If you are fighting diabetes, stick to low glycemic foods like non-starchy vegetables, stone fruits and berries, nuts, seeds, avocados, coconut, organic meat, eggs, wild-caught fish, and raw pastured dairy.

One benefit of these foods is that they generally promote weight loss, which is a major factor in reversing diabetes. A study following 306 diabetic individuals found that losing weight under a structured program (with the supervision of a primary care physician) resulted in almost half of the participants going into total diabetes remission. This means they were able to stay off their medications permanently (assuming they stayed on a healthy diet). Quality of life also improved by over seven points on average for the patients on the dietary regimen, while it decreased by about three points for the control group. (12)
Step 3: Take These Supplements for Diabetes

1. Chromium Picolinate

Taking 200 micrograms of chromium picolinate three times daily with meals can help improve insulin sensitivity. A review published in Diabetes Technology and Therapeutics evaluated 13 studies that reported significant improvement in glycemic control and substantial reductions in hyperglycemia and hyperinsulinemia after patients used chromium picolinate supplementation. Other positive outcomes from supplementing with chromium picolinate included reduced cholesterol and triglyceride levels and reduced requirements for hypoglycemic medication. (13)

2. Cinnamon

Cinnamon has the ability to lower blood sugar levels and improve your sensitivity to insulin. A study conducted at Western University of Health Sciences in Pomona, Calif. found that the consumption of cinnamon is associated with a statistically significant decrease in plasma glucose levels, LDL cholesterol and triglyceride levels. Cinnamon consumption also helped increase HDL cholesterol levels. (14)

To take advantage of the many health benefits of cinnamon, add one teaspoon to food, smoothies or tea. You can also take one to two drops of cinnamon essential oil internally by adding it to food or tea, or combine three drops of cinnamon oil with half a teaspoon of coconut oil and massage it into your wrists and abdomen.

3. Fish Oil

Taking a fish oil supplement can help improve markers of diabetes by reducing triglyceride levels and raising HDL cholesterol levels. Research published in the Journal of Research in Medical Sciences shows that omega-3 fatty acids found in fish oil are necessary for proper insulin function, preventing insulin intolerance and reducing inflammation. (15) To use fish oil as a natural remedy for diabetes, take 1,000 milligrams daily.
4. Alpha Lipoic Acid

Alpha lipoic acid is an antioxidant that helps turn glucose into fuel for the body. It effectively improves insulin sensitivity and reduces symptoms of diabetic neuropathy, such as weakness, pain and numbness thatís caused by nerve damage. Although we make alpha lipoic acid and it can be found in some food sources, like broccoli, spinach and tomatoes, taking an ALA supplement will increase the amount that circulates in your body, which can be extremely beneficial when trying to reverse diabetes naturally. (16)
5. Bitter Melon Extract

Bitter melon helps lower blood glucose levels, and it regulates the bodyís use of insulin. Studies show that bitter melon extract can help reduce and manage symptoms of diabetes, including insulin resistance, heart complications, kidney damage, blood vessel damage, eye disorders and hormone irregularities. (17)
Step 4: Follow This Eating Plan to Reverse Diabetes

If you want to balance your blood sugar and see results quickly, then follow this diabetes eating plan as closely as possible. Focus on getting plenty of clean protein, healthy fats and fiber into every meal, which can help reverse diabetes.

Start by trying these first three days of the plan, and then use a combination of these foods going forward. Review the list of foods that you should be eating from Step 2, and bring those healthy, diabetes-fighting foods into your diet as well. It may seem like a major change to your diet at first, but after some time you will begin to notice the positive effects these foods are having on your body.

Diabetes meal plan - Dr. Axe

Some other recipes that fit into this eating plan include:

Eggs Benedict Recipe
Turkey-Stuffed Bell Peppers
Cucumber Salad Recipe
Buffalo Cauliflower

Step 5: Exercise to Balance Blood Sugar

Exercise reduces chronic disease and can help reverse diabetes naturally. Studies show that exercise improves blood glucose control and can prevent or delay type 2 diabetes, while also positively affecting your blood pressure, heart health, cholesterol levels and quality of life. (18)

Exercise naturally supports your metabolism by burning fat and building lean muscle. To prevent and reverse diabetes, make exercise a part of your daily routine. This doesnít necessary mean that you have to spend time at the gym. Simple forms of physical activity, like getting outside and walking for 20 to 30 minute every day, can be extremely beneficial, especially after meals. Practicing yoga or stretching at home or in a studio is another great option.

In addition to walking and stretching exercises, try interval training cardio, like burst training, or weight training three to five days a week for 20ñ40 minutes. Burst training can help you burn up to three times more body fat than traditional cardio and can naturally increase insulin sensitivity. You can do this on a spin bike with intervals, or you can try burst training at home.

Strength training using free weights or machines is also recommended because it helps you build and maintain muscle, which supports balanced blood sugar and sugar metabolism.
Final Thoughts on How to Reverse Diabetes

More than 30 million people ó nearly 10 percent of the population ó have diabetes in the U.S., including children. Almost 7.2 million of those people arenít even aware of it.
Another 34 million adults are prediabetic.
Itís the seventh leading cause of death in the U.S. and costs hundreds of billions of dollars per year.
Type 1 diabetes typically occurs before someone turns 20 and is rarely reversed, but it can be managed through diet and lifestyle changes.
Type 2 diabetes is more common and usually occurs in people over 40, especially if theyíre overweight.
In order to reverse diabetes naturally, remove foods like refined sugar, grains, conventional cowís milk, alcohol, GMO foods and hydrogenated oils from your diet; incorporate healthy foods like foods high in fiber, chromium, magnesium, healthy fats and clean protein, along with foods with low glycemic loads; take supplements for diabetes; follow my diabetic eating plan; and exercise to balance blood sugar.

Abdominal pain definition and facts
What is abdominal pain?
What causes abdominal pain?
Signs, symptoms, locations, types, and severity of abdominal pain
How is the cause of abdominal pain diagnosed?
What exams and tests help diagnose the cause of abdominal pain?
How does IBS (irritable bowel syndrome) cause abdominal pain?
Foods, natural remedies, and OTC treatments for certain causes of abdominal pain
Why can diagnosis of the cause of abdominal pain be difficult?
What medications can be used to treat certain causes of abdominal pain?
What lifestyle choices can I make to prevent abdominal pain?
When should I call my doctor about abdominal pain?

A woman on her bed experiencing abdominal pain.
Abdominal pain definition and facts

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Abdominal (belly) pain is pain or discomfort that is felt in the part of the trunk below the ribs and above the pelvis.
It comes from organs within the abdomen or organs adjacent to the belly.
It is caused by inflammation, distention of an organ, or by loss of the blood supply to an organ.
In irritable bowel syndrome (IBS) it may be caused by contraction of the intestinal muscles or hyper-sensitivity to normal intestinal activities.
Symptoms associated with it may include:
Bloating
Belching
Gas (flatus, farting)
Indigestion
Discomfort in the upper left or right; middle; or lower left or right abdomen
Constipation
Diarrhea
GERD (gastro-esophageal reflux disease)
Heartburn
Chest discomfort
Pelvic discomfort
The cause of abdominal pain is diagnosed on the basis of its characteristics, the physical examination, and testing. Occasionally, surgery is necessary for diagnosis.
The medical diagnosis of the cause is challenging because the characteristics may be atypical, tests are not always abnormal, diseases causing pain may mimic each other, and the characteristics of the pain may change over time.
Medical treatment depends upon the patient’s history of disease or other health conditions that may be the cause.

What is abdominal pain?

Abdominal pain is felt in the abdomen. The abdomen is an anatomical area that is bounded by the lower margin of the ribs and diaphragm above, the pelvic bone (pubic ramus) below, and the flanks on each side. Although pain can arise from the tissues of the abdominal wall that surround the abdominal cavity (such as the skin and muscles), the term abdominal pain generally is used to describe discomfort originating from organs within the abdominal cavity. Organs of the abdomen include the stomach, small intestine, colon, liver, gallbladder, spleen, and pancreas.

Technically, the lowermost portion of the area described previously, is the pelvis, which contains the urinary bladder and rectum, as well as the prostate gland in men, and the uterus, Fallopian tubes, and ovaries in women. Often, it can be difficult to know if lower abdominal pain is coming from the lower abdomen or pelvis (pelvic pain).

Occasionally, pain may be felt in the belly even though it is arising from organs that are close to, but not within, the abdominal cavity, for example, conditions of the lower lungs, the kidneys, and the uterus or ovaries. On the other hand, it also is possible for pain from organs within the belly to be felt outside of the it. For example, the pain of pancreatic inflammation may be felt in the back. These latter types of pain are described as "referred” because it does not originate in the location that it is felt. Rather, the cause is located away from where it is felt (i.e., it is referred to a different area).

Picture of the organs and glands in the abdomen.

Picture of the organs and glands in the abdomen

What causes abdominal pain?

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Abdominal pain is caused by inflammation of an organ (for example, appendicitis, diverticulitis, colitis), by stretching or distention of an organ (for example, obstruction of the intestine, blockage of a bile duct by gallstones, swelling of the liver with hepatitis), or by loss of the supply of blood to an organ (for example, ischemic colitis).

To complicate matters, however, abdominal pain also can occur without inflammation, distention or loss of blood supply. An important example of the latter is the irritable bowel syndrome (IBS). It is not clear what causes the belly pain in IBS, but it is believed to be due either to abnormal contractions of the intestinal muscles (for example, spasm) or abnormally sensitive nerves within the intestines that give rise to painful sensations inappropriately (visceral hyper-sensitivity). This often is referred to as functional pain because no recognizable specific abnormality to account for the cause of the pain has been found - at least not yet.
Quick GuideWhat's Causing Your Abdominal Pain?
What's Causing Your Abdominal Pain?
Abdominal Pain Causes

Abdominal pain is a common symptom, and most people have experienced some sort of abdominal pain (belly or stomach pain). Causes of more serious causes of abdominal pain include:

Bloody stools
Black tarry stools
Dehydration
Painful urination
Lack of urination
Abrupt cessation of bowel movements
Dehydration

Learn more about abdominal pain causes »
A collage highlighting the locations of abdominal pain on a female model at various angles.
Signs, symptoms, locations, types, and severity of abdominal pain

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Doctors will ask you a variety of questions about your belly pain in order to help find the possible causes of it, for example:
How did the pain begin?

If it comes on suddenly, this may suggest a problem with an organ within the belly; for example, the interruption of the supply of blood to the colon (ischemia) or obstruction of the bile duct by a gallstone (biliary colic).

Where is the pain located?

Appendicitis typically causes discomfort in the middle of the abdomen, and then moves to the right lower abdomen, the usual location of the appendix.
Diverticulitis typically causes discomfort in the left lower abdomen where most colonic diverticuli are located.
Discomfort from the gallbladder (biliary colic or cholecystitis) typically is felt in the middle, upper abdomen or the right upper abdomen near where the gallbladder is located.

What is the type and pattern of the pain?

Is it severe, crampy, steady; or does it wax and wane? Obstruction of the intestine initially causes waves of crampy pain due to contractions of the intestinal muscles and distention of the intestine. True cramp-like pain suggests vigorous contractions of the intestines.
Obstruction of the bile ducts by gallstones typically causes steady (constant) upper belly pain that lasts between 30 minutes and several hours.
Acute pancreatitis typically causes severe, unrelenting, steady pain in the upper abdomen and upper back.
The pain of acute appendicitis initially may start near the umbilicus, but as the inflammation progresses, it moves to the right lower abdomen.
The character of pain may change over time. For example, obstruction of the bile ducts sometimes progresses to inflammation of the gallbladder with or without infection (acute cholecystitis). When this happens, the characteristics change to those of inflammatory pain.

How long does the pain last?

The discomfort of IBS typically waxes and wanes over months or years and may last for years or decades.
Biliary colic lasts no more than several hours.
The pain of pancreatitis lasts one or more days.
The pain of acid-related diseases - gastroesophageal reflux disease (GERD) or duodenal ulcers - typically occurs over a period of weeks or months that is worse followed by periods of weeks or months during which it is better (periodically).
Functional pain may show this same pattern of periodicity.

What makes the pain worse?

Pain due to inflammation (appendicitis, diverticulitis, cholecystitis, and pancreatitis) typically is aggravated by sneezing, coughing or any jarring motion. Individuals with inflammation prefer to lie still.
What health conditions make abdominal pain worse or better?

What relieves the pain?

The pain of IBS and constipation often is relieved temporarily by bowel movements and may be associated with changes in bowel habit.
Pain due to obstruction of the stomach or upper small intestine may be relieved temporarily by vomiting which reduces the distention that is caused by the obstruction.
Eating or taking antacids may temporarily relieve ulcer pain from the stomach or duodenum because both food and antacids neutralize the acid that is responsible for irritating the ulcers and causing the pain.
Pain that awakens a patient from sleep is more likely to be due to non-functional causes and is more significant.
Other associated symptoms that accompany abdominal pain may suggest:
Fever suggests inflammation or infection.
Diarrhea or rectal bleeding suggests an intestinal cause.
Fever and diarrhea suggest inflammation of the intestines that may be infectious or non-infectious.
How is the cause of abdominal pain diagnosed?
Doctors determine the cause of the pain by relying on:
Its characteristics, physical signs, and other accompanying symptoms
Findings on physical examination
Medical laboratory, radiological, and endoscopic testing
Surgery

How is the cause of abdominal pain diagnosed?

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Doctors determine the cause of the pain by relying on:

Characteristics, physical signs, and other accompanying symptoms
Findings on physical examination
Laboratory, radiological, and endoscopic testing
Surgery

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A doctor examines a small boy that is experiencing stomach and abdominal pain.
What exams and tests help diagnose the cause of abdominal pain?
Physical examination

Examining the patient will provide the doctor with additional clues to the cause of the pain. The doctor will determine:

The presence of sounds coming from the intestines that occur when there is obstruction of the intestines,
The presence of signs of inflammation (by special maneuvers during the examination),
The location of any tenderness
The presence of a mass within the abdomen that suggests a tumor, enlarged organ, or abscess (a collection of infected pus)
The presence of blood in the stool that may signify an intestinal problem such as an ulcer, colon cancer, colitis, or ischemia.

For example:

Finding tenderness and signs of inflammation in the left lower abdomen often means that diverticulitis is present, while finding a tender (inflamed) mass in the same area may mean that the inflammation has progressed and that an abscess has formed.
Finding tenderness and signs of inflammation in the right lower abdomen often means that appendicitis is present, while finding a tender mass in the same area may mean that the inflammation has progressed and that an abscess has formed.
Inflammation in the right lower abdomen, with or without a mass, also may be found in Crohn's disease. (Crohn's disease most commonly affects the last part of the small intestine, usually located in the right lower abdomen.)
A mass without signs of inflammation may mean that a cancer is present.

While the health history and physical examination are vitally important in determining the cause of abdominal pain, other medical tests often are necessary to determine the cause.
Laboratory tests

Laboratory tests such as the complete blood count (CBC), liver enzymes, pancreatic enzymes (amylase and lipase), pregnancy test and urinalysis are frequently ordered.

An elevated white count suggests inflammation or infection (as with appendicitis, pancreatitis, diverticulitis, or colitis).
A low red blood cell count may indicate a bleed in the intestines.
Amylase and lipase (enzymes produced by the pancreas) commonly are elevated in pancreatitis.
Liver enzymes may be elevated with gallstone attacks or acute hepatitis.
Blood in the urine suggests kidney stones.
When there is diarrhea, white blood cells in the stool suggest intestinal inflammation or infection.
A positive pregnancy test may indicate an ectopic pregnancy (a pregnancy in the fallopian tube instead of the uterus).

Plain X-rays of the abdomen

Plain X-rays of the abdomen also are referred to as a KUB (because they include the kidney, ureter, and bladder). The KUB may show enlarged loops of intestines filled with copious amounts of fluid and air when there is intestinal obstruction. Patients with a perforated ulcer may have air escape from the stomach into the abdominal cavity. The escaped air often can be seen on a KUB on the underside of the diaphragm. Sometimes a KUB may reveal a calcified kidney stone that has passed into the ureter and resulted in referred abdominal pain or calcifications in the pancreas that suggest chronic pancreatitis.
Radiographic studies

Ultrasound is useful in diagnosing gallstones, cholecystitis appendicitis, or ruptured ovarian cysts as the cause of the pain.
Computerized tomography (CT) of the abdomen is useful in diagnosing pancreatitis, pancreatic cancer, appendicitis, and diverticulitis, as well as in diagnosing abscesses in the abdomen. Special CT scans of the abdominal blood vessels can detect diseases of the arteries that block the flow of blood to the abdominal organs.
Magnetic resonance imaging (MRI) is useful in diagnosing many of the same conditions as CT tomography.
Barium X-rays of the stomach and the intestines (upper gastrointestinal series or UGI with a small bowel follow-through) can be helpful in diagnosing ulcers, inflammation, and blockage in the intestines.
Computerized tomography (CT) of the small intestine can be helpful in diagnosing diseases in the small bowel such as Crohn's disease.
Capsule enteroscopy, uses a small camera the size of a pill swallowed by the patient, which can take pictures of the entire small bowel and transmit the pictures onto a portable receiver. The small bowel images can be downloaded from the receiver onto a computer to be inspected by a doctor later. Capsule enteroscopy can be helpful in diagnosing Crohn's disease, small bowel tumors, and bleeding lesions not seen on x-rays or CT scans.

Endoscopic procedures

Esophagogastroduodenoscopy or EGD is useful for detecting ulcers, gastritis (inflammation of the stomach), or stomach cancer.
Colonoscopy or flexible sigmoidoscopy is useful for diagnosing infectious colitis, ulcerative colitis, or colon cancer.
Endoscopic ultrasound (EUS) is useful for diagnosing pancreatic cancer or gallstones if the standard ultrasound or CT or MRI scans fail to detect them.
Balloon enteroscopy, the newest technique allows endoscopes to be passed through the mouth or anus and into the small intestine where small intestinal causes of pain or bleeding can be diagnosed, biopsied, and treated.

Surgery. Sometimes, diagnosis requires examination of the abdominal cavity either by laparoscopy or surgery.
Abdominal Pain: Causes, Symptoms and Diagnosis

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Pelvic Pain Pictures Slideshow
Appendicitis Symptoms & Appendectomy Surgery

Appendicitis & Appendectomy Slideshow Pictures
An illustration of a constipated colon which is associated with irritable bowel syndrome (IBS).
How does IBS (irritable bowel syndrome) cause abdominal pain?

As previously mentioned, the discomfort of irritable bowel syndrome is due either to abnormal intestinal muscle contractions or visceral hypersensitivity. Generally, abnormal muscle contractions and visceral hypersensitivity are much more difficult to diagnose than other diseases or other health conditions, particularly since there are no typical abnormalities on physical examination or the usual diagnostic tests. The diagnosis is based on the history (typical symptoms) and the absence of other cause.
Foods, natural remedies, and OTC treatments for certain causes of abdominal pain

If you aren’t sure if you need to seek medical advice for belly pain, contact your doctor or other health care professional before using any home remedies.

Common home remedies and over-the-counter (OTC) medicines include:

Eat less food
Take small amounts of baking soda
Use lemon and/or lime juice
Start a BRAT diet (banana, rice, applesauce and toast) for a day or so for symptom relief.
Don’t smoke or drink alcohol.

Some health care professionals recommend:

Taking ginger
Peppermint
Licorice
Chamomile tea
Medications such as bismuth subsalicylate (Pepto-Bismol), loperamide (Imodium), ranitidine (Zantac) and other over-the-counter substances

Some of these may help reduce symptoms, but if symptoms persist, seek medical care. Beware of "cures" advertised as a single treatment that can cure all causes of this problem because no such remedy or cure exists.

Taking aspirin or NSAIDs should be avoided until the cause of the pain is diagnosed because the medications could make some causes worse (for example, peptic ulcers, intestinal bleeding).
Why can diagnosis of the cause of abdominal pain be difficult?

Modern advances in technology have greatly improved the accuracy, speed, and ease of establishing the cause of belly pain, but significant challenges remain. There are many reasons why diagnosing the cause of it can be difficult.
Symptoms may be atypical

For example, the pain of appendicitis sometimes is located in the right upper abdomen, and of diverticulitis on the right side. Elderly patients and those taking corticosteroids may have little or no pain and tenderness when there is inflammation, for example, with cholecystitis or diverticulitis. This occurs because corticosteroids reduce the inflammation.

Tests are not always abnormal.

Ultrasound examinations can miss gallstones, particularly small ones.
CT scans may fail to show pancreatic cancer, particularly small ones.
The KUB can miss the signs of intestinal obstruction or stomach perforation.
Ultrasounds and CT scans may fail to demonstrate appendicitis or even abscesses, particularly if the abscesses are small.
The CBC and other blood tests may be normal despite severe infection or inflammation, particularly in individuals receiving corticosteroids or other drugs that suppress the immune system.

Diseases can mimic one another.

IBS symptoms can mimic bowel obstruction, cancer, ulcer, gallbladder attacks, or even appendicitis.
Crohn's disease can mimic appendicitis.
Infection of the right kidney can mimic acute cholecystitis.
A ruptured right ovarian cyst can mimic appendicitis; while a ruptured left ovarian cyst can mimic diverticulitis.
Kidney stones can mimic appendicitis or diverticulitis.

The characteristics of the pain may change.

Examples discussed previously include the extension of the inflammation of pancreatitis to involve the entire abdomen and the progression of biliary colic to cholecystitis.

A close up of a doctor holding a bottle of pills and writing a prescription.
What medications can be used to treat certain causes of abdominal pain?

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Medications that are used for the treatment of underlying cause(s) of the pain are the medications of choice. For example, medications are not needed for the treatment of simple viral gastroenteritis (stomach flu or stomach bug), while surgery and/or chemotherapy may be the best approach to treat certain cancers in the abdomen. Other causes may require antispasmodics, antimicrobials, H2 blockers, or even nitrates or morphine. The diagnosed cause usually narrows the choice of medications. A few causes can only be treated by surgery (for example incarcerated hernia, abdominal adhesions from previous surgeries, and certain abdominal injuries), although some medications may be used (for example, morphine) while the person is waiting to have surgery.
What lifestyle choices can I make to prevent abdominal pain?

Lifestyle changes really depend on the cause of the pain.

Eat a healthy diet, exercise, and avoid smoking and excess alcohol consumption to reduce the chances that you will experience certain causes.
Good hygiene, especially hand washing and avoiding materials and foods contaminated with viruses and bacteria will reduce your chances of developing illness from many infectious causes.

When should I call my doctor about abdominal pain?

Some doctors suggest that if you have a "less serious" cause of abdominal pain you likely won’t need to see a doctor if the symptoms resolve in about 24 to 48 hours. For example, if you have viral or bacterial food poisoning, have had discomfort, but aren’t dehydrated.

If you have a chronic problem that occasionally causes abdominal discomfort, most doctors suggest you contact the person treating you for the ailment for an appointment or prescription (refill). However, if you have any of the problems or symptoms listed in the "serious abdominal pain "section above, you should seek immediate medical care.
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Medically Reviewed on 11/10/2017
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Colonoscopy
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Colon Cancer Slideshow
Colorectal cancer (colon cancer) is the cause of many cancer deaths. Learn about the warning signs, symptoms, screening process, stages, and treatment related to colorectal cancer.
Complete Blood Count
A complete blood count (CBC) is a calculation of the cellular makeup of blood. A CBC measures:
the concentration of white blood cells, red blood cells, platelets in the blood, and aids in diagnosing conditions and disease such as
malignancy, anemia, or blood clotting problems.
Diarrhea
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Endometriosis

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abdominal pain, nausea, vomiting, difficulty swallowing, or intestinal bleeding.
Gastroenteritis (Stomach Flu)

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Abdominal Pain: What You Should Know
In this Article

What Are the Most Common Causes of Abdominal Pain?
When Should You Contact Your Doctor?
How Does Your Doctor Figure Out the Cause of Your Abdominal Pain?

Just about everybody at one time or another will get a bellyache. Most causes of abdominal pain aren't worrisome, and your doctor can easily diagnose and treat the problem. Sometimes, though, it can be a sign of a serious illness. Learn which symptoms to watch out for and when you should get medical help.
What Are the Most Common Causes of Abdominal Pain?

Whether you've got a mild stomachache, sharp pain, or cramps, abdominal pain can have many causes. For instance, you might have indigestion, constipation, a stomach virus, or, if you're a woman, menstrual cramps.

Other possible causes include:

Irritable bowel syndrome (IBS)
Crohn's disease
Food poisoning
Food allergies
Gas

You may also get abdominal pain if you're lactose intolerant or have ulcers or pelvic inflammatory disease. Some other causes include:

Hernia
Gallstones
Kidney stones
Endometriosis
Gastroesophageal reflux disease (GERD)
Appendicitis

When Should You Contact Your Doctor?

If your abdominal pain is severe, doesn't go away, or keeps coming back, talk to your doctor. Call 911 right away if your belly hurts because you had a recent injury there or if you have any chest pain.
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You should also contact her as soon as you can if you have symptoms along with the pain, such as:

Fever
Can't keep food down for more than 2 days
Signs you're getting dehydrated
Can't have a bowel movement, especially if you're also vomiting
Pain when you pee, or you need to urinate often

Also call your doctor if:
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Your belly is tender to the touch.
Pain lasts more than a few hours.

You may also get symptoms that could be a sign of a problem inside your body that needs treatment as soon as possible. For example, get medical care right away if you have abdominal pain and you also:

Vomit blood
Notice bloody or black, tarry bowel movements
Have trouble breathing
Vomit constantly
Have swelling in your belly
Have yellow skin
Are pregnant

How Does Your Doctor Figure Out the Cause of Your Abdominal Pain?

Since there are so many possible causes, your doctor will do a thorough physical exam. She'll also ask you some questions about your symptoms. She'll want to know what type of pain you have. For instance, is it a severe stabbing pain or a dull ache?

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Abdominal pain

Find possible causes of abdominal pain based on specific factors. Check one or more factors on this page that apply to your symptom.
Pain is

Burning
Crampy
Dull
Gnawing
Intense
Intermittent or episodic

Ongoing (chronic)
Sharp
Steady
Sudden (acute)
Worsening or progressing

Pain located in

Abdomen but radiates to other parts of the body
Lower abdomen
Middle abdomen

One or both sides
Upper abdomen

Triggered or worsened by

Coughing or other jarring movements
Drinking alcohol
Eating certain foods

Menstrual cycle
Stress

Relieved by

Antacids
Avoiding certain foods
Changing position

Drinking more water
Eating certain foods
Eating more fiber

Accompanied by

Abdominal swelling
Black or bloody stools
Constipation
Diarrhea
Fever
Inability to move bowels in spite of urge
Loose, watery stools

Nausea or vomiting
Passing gas
Pulsing sensation near the navel
Rash
Stomach growling or rumbling
Unintended weight loss
Urgent need to have a bowel movement

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Abdominal Pain (Adults)
Medical Author:
Jerry R. Balentine, DO, FACEP
Medical Editor:
Jay W. Marks, MD

Facts and Definition of Abdominal Pain in Adults

Abdominal pain is the feeling of pain in a person's stomach, upper or lower abdomen, and can range in intensity from a mild stomach ache to severe acute pain.
Causes of symptoms of abdominal pain vary and may include gallbladder disease, ulcers of the stomach, food poisoning, diverticulitis, appendicitis, cancers, gynecologic (for example, fibroids, cysts, sexually transmitted diseases - STDs), and vascular problems.
Some women experience abdominal pain during pregnancy.
Abdominal pain can be acute or chronic and include sharp pain as well as dull pain.
The location of the abdominal pain may be in the upper right or left side (quadrant), lower right or left side, and upper, middle, and lower.
The cause of abdominal pain is diagnosed by a combination of history (questions the doctor asks you about your problem), physical examination (examination by a doctor), and testing (for example, X-rays and blood tests).
Treatment for abdominal pain depends upon the cause and may include anything from observation, medications, and procedures that include endoscopy, and surgery.
The prognosis for abdominal pain depends on the cause and the promptness of medical care and diagnosis.

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Type and Location of the Abdominal Pain

The type and location of pain may help the doctor find the cause. The intensity and duration of pain must also be considered when making a diagnosis. A few general characteristics of abdominal pain are:

What the pain feels like: Abdominal pain can be sharp, dull, stabbing, cramp-like, knifelike, twisting, or piercing. Many other types of pain are also possible.
How long the pain lasts: Abdominal pain can be brief, lasting for a few minutes, or it may persist for several hours and longer. Sometimes abdominal pain comes on strongly for a while and then lessens in intensity for a while. Is the pain continuous or does it come and go?
Events that trigger pain: The pain may be worsened or relieved by certain events, such as worse after meals, better with a bowel movement, better after vomiting, or worse when lying down. Do certain foods trigger the pain?
Location of the pain - The location often will help your doctor diagnose the cause of the pain.
Upper left abdominal pain: Enlarged spleen
Upper right abdominal pain: Gallbladder disease, hepatitis
Lower left abdominal pain: Diverticulitis, ovarian cysts, ovarian torsion
Lower right abdominal pain: Appendicitis, right ovary problems
Upper abdominal pain: Stomach ulcers, gastritis, pancreatitis
Lower abdominal pain: Urinary tract infections, gynecologic problems like uterine fibroids and cancer

Abdominal Pain Causes and Location (Right, Left, Lower, Upper)

Abdominal pain is caused by

inflammation (appendicitis, diverticulitis, colitis),
by stretching or distention of an organ (for example, gallstones, hepatitis), or
by loss of the supply of blood to an organ (for example, ischemic colitis).

Learn more about the causes of abdominal pain »

What are Symptoms of Abdominal Pain in Adults?

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Abdominal pain is a symptom. It may mean that the person has a medical problem that needs treatment.

Abdominal pain may go along with other symptoms. Keep track of your symptoms because this will help the doctor find the cause of your pain. Make a special note if there is sudden abdominal pain, severe abdominal pain after eating, or abdominal pain with diarrhea.

What Are the Causes of Abdominal Pain in Adults?

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Many acute (short-duration) and chronic (long-duration) diseases cause abdominal pain.

The diseases that most people are concerned about having are gastritis, appendicitis, kidney stones, gallbladder pain disease, duodenal and gastric ulcers, infections, and pregnancy-associated problems since these are the most common. Doctors also are concerned about ruptured blood vessels, heart attacks, liver and pancreas inflammation, kidney stones, problems with the blood circulation to the intestine, diverticulitis, cancers, and other diseases.

Abdominal pain may not arise from the abdomen.

Some heart attacks and pneumonias can cause abdominal pain, and even nausea.
Diseases of the pelvis or groin can also cause abdominal pain in adults.
Testicular problems often can cause lower abdominal pain.
Certain skin rashes, such as shingles, can feel like abdominal pain, even though the person has nothing wrong inside their body.
Even some poisonings and bites, such as a black widow spider bite, can cause severe abdominal pain.

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What are Some of the Causes of Abdominal Pain by Location?

Abdominal pain can occur in any area of the abdomen. You might experience pain in one area of the abdomen although the cause for the pain is in a different area. Some diseases can cause pain in multiple areas of the abdomen. Below are the usual pain patterns associated with diseases, but please note that this does not include all diseases and conditions, and the below do not hold true all of the time.
Pain in the Upper Abdomen

Stomach Ulcers
Gastritis
Pancreatitis

Pain in the Upper Right Side

Gallbladder Disease
Liver Inflammation (Hepatitis)

Pain in the Upper Left Side

Enlarged Spleen

Pain in the Lower Right Side

Other diseases and conditions of the uterus
Appendicitis
Right Ovarian Inflammation or Torsion
Right Ovarian Cyst

Pain in the Lower Left Side

Diverticulitis
Left Ovarian Inflammation or Torsion
Left Ovarian Cyst

Pain in the Lower Abdomen

Urinary tract infections (UTI)
Fibroids

From the above it is apparent that abdominal pain can have many causes, some linked directly to the abdomen and others caused by non-abdominal disease. Sometimes the cause of abdominal pain is not determined, and the you may be asked to return the next day to recheck and you perhaps need more tests. In some cases, no specific cause is determined, and the pain gets better in hours or days.

When Should an Adult Seek Medical Care for Abdominal Pain?

Call or see a doctor if the affected person has any of the following:

Abdominal pain that lasts more than six hours or continues to worsen
Severe abdominal pain
Abdominal pain after eating
Pain that stops a person from eating
Pain accompanied by vomiting more than three or four times
Abdominal pain during pregnancy
Pain that worsens when a person tries to move around
Pain that starts all over, but settles into one area, especially the right lower abdomen
Pain that awakens a person up at night
Pain with vaginal bleeding or pregnancy, even if a female only thinks she might be pregnant
Pain accompanied by fever over 101 F (38.3 C)
Pain along with inability to urinate, move the bowels, or pass gas
Any other pain that feels different from a simple stomach ache
Any other pain that alarms a person, or concerns them in any way

If the person has any of the following, or cannot reach their doctor, go to a hospital emergency department:

Very severe pain
Pain so bad the affected person passes out or almost passes out
Pain so bad the affected person cannot move
Pain and vomiting blood, or any vomiting that lasts more than six hours
Pain and no bowel movement for more than three days
Pain the person thinks might be in their chest, but they aren't sure
Pain that seems to come from the person's testicles

What Kind of Doctor Treats Abdominal Pain in Adults?

Abdominal pain can be treated by a variety of doctors depending on the cause of the pain. It is usually best to start off with a primary care physician who can start the process of diagnosing the origin of the pain. Depending on the final diagnosis you will be treated by a primary care doctor (i.e. ulcers, infection) or referred to a surgeon (appendicitis, ovarian torsion), gastroenterologist, or gynecologist. If the pain is severe you might end up in the emergency department where an emergency medicine physician will be the first one to take care of you.
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What Questions will the Doctor ask about my Abdominal Pain?

Diagnosing the cause of abdominal pain is one of the hardest tasks for a doctor. Sometimes all that the professional can do is be sure that the pain does not require surgery or admission to the hospital.

The healthcare professional may ask these or similar questions to try to determine what is causing the patient's pain. Some may seem unrelated to the patient's current condition, but it is important to try to answer them as completely as possible. The answers to these questions can help the healthcare professional find the cause of the patient's pain more quickly and easily.

How long have you had the pain?
What were you doing when it started?
How did you feel before the pain started?
Have you felt OK over the last few days?
What have you tried to make the pain better? Did it work?
What makes the pain worse?
Where is the pain located?
Right side?
Left side?
Does the pain make you want to stay in one place or move around?
How was the ride to the hospital? Did riding in the car hurt you?
Is the pain worse when you cough?
Have you thrown up?
Did throwing up make the pain better or worse?
Have your bowel movements been normal?
When was your last bowel movement?
Are you passing gas?
Do you feel you might have a fever?
Have you had a pain like this before? When? What did you do for it?
Have you ever had surgery? What surgery? When?
Are you pregnant? Are you sexually active? Are you using birth control?
Have you been around anyone with symptoms like this?
Have you traveled out of the country recently?
When did you eat last? What did you eat?
Did you eat anything out of the ordinary?
Did your pain start all over your stomach and move to one place?
Does the pain go into your chest? Into your back? Where does it go?
Can you cover the pain with the palm of your hand, or is the hurting area bigger than that?
Does it hurt to breathe?
Do you have any medical problems such as heart disease, diabetes, or AIDS?
Do you take steroids? Pain medicine such as aspirin or Motrin?
Do you take antibiotics? Over-the-counter pills, herbs, or supplements?
Do you drink alcohol? Coffee? Tea?
Do you smoke cigarettes?
Of course, the doctor may not need to ask all if these questions or may need to ask additional questions depending on the symptoms.

How Is the Cause of the Abdominal Pain Diagnosed?

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Physical Examination

Physical examination will include a careful examination of the patient's abdomen, heart, and lungs in order to pinpoint the source of the pain.

The doctor will touch different parts of the abdomen to check for tenderness or other signs that indicate the source of the pain.
The doctor may do a rectal exam to check for small amounts of blood in the stool or other problems, such as a mass or internal hemorrhoids.
If the patient is a man, the doctor may check the penis and testicles.
If the patient is a woman, the doctor may do a pelvic exam to check for problems in the uterus, Fallopian tubes, and ovaries.
The doctor also may look at the patient's eyes for yellow discoloration (jaundice) and in the mouth to be sure the patient is not dehydrated.

Laboratory Tests

Laboratory tests may or may not help to determine the cause of the abdominal pain. Combined with the information gained from the questions the patient was asked and the physical examination performed by the doctor, certain blood or urine tests may be ordered and could assist in determining the diagnosis.

One of the most important tests is to see if a woman is pregnant.
A raised white blood cell count may mean infection or may just be a reaction to the stress of pain and vomiting.
A low red blood count (hemoglobin) may mean that a patient is bleeding internally, but most conditions that involve bleeding are not painful.
Blood in the urine, which may not be visible to the eye, suggests that a patient may have a kidney stone.
Other blood tests, such as liver enzymes and pancreas enzymes, can help determine which organ is the cause of the pain, but they do not point to a diagnosis.

Radiology Tests

Radiology studies of the patient's abdomen can be useful, but are not always necessary or helpful.

Occasionally, an X-ray will show air outside of the bowel, meaning that something has ruptured or perforated.
An X-ray also can help diagnose bowel obstruction.
Sometimes X-rays can show a kidney stone.

Ultrasound is a painless procedure useful in finding some causes of abdominal pain.

This may be done if the doctor suspects problems with the gallbladder, pancreas, liver, or the reproductive organs of women.
Ultrasound also assists in the diagnosis of problems with the kidneys and the spleen, or the large blood vessels that come from the heart and supplies blood to the lower half of the body.

Computerized tomography (CT scan) provides useful information about the liver, pancreas, kidneys and ureters, spleen, and small and large intestine.

The patient and doctor should discuss the need for an X-ray or CT scan and their associated radiation exposure before proceeding with any radiological examination.

MRI is usually less helpful than a CT scan when the abdomen is examined, although with certain problems and symptoms your healthcare professional may order an MRI rather than a CT scan or in follow up to any of the above examinations.

The doctor may perform no tests at all. The cause of the patient's pain may be clear without any tests and may be known not to be serious. If the patient does undergo tests, the professional should explain the reason for the test and any contraindications. When the results are available, the professional should discuss them with the patient, as well as whether the results impact the treatment.
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What Home Remedies Soothe Abdominal Pain in Adults?

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Abdominal pain without fever, vomiting, vaginal bleeding, passing out, chest pain, or other serious symptoms often get better without special treatment.

If the pain persists or if a person believes the pain may represent a serious problem, they should see a doctor.
A heating pad or soaking in a tub of warm water may ease pain.
Over-the-counter (OTC) antacids, such as Tums, Maalox, or Pepto-Bismol, also can reduce some types of abdominal pain. Activated charcoal capsules also may help.
Acetaminophen (common brand names are Arthritis Foundation Pain Reliever, Aspirin Free Anacin, Panadol, Tylenol) may help. This product should be avoided if liver disease is suspected. Patients should try to avoid aspirin or ibuprofen (common brand names are Advil, Motrin, Nuprin, Pamprin IB) stomach or intestinal ulcer disease is suspected; these drugs can make the pain worse.

What is the Medical Treatment for Causes of Abdominal Pain in Adults?

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The patient's treatment will depend on what the doctor thinks is causing the abdominal pain.

The patient may be given IV (intravenous) fluids. The doctor may ask the patient not to eat or drink anything until the cause of the pain is known. This is done to avoid worsening certain medical conditions (for example adding food to the stomach if there is a ruptured ulcer) or to prepare the patient in case they need to have surgery. (An empty stomach is better when general anesthesia is needed.)

The patient may be given pain medication.

For pain caused by bowel spasm, they may be given a shot in the hip, arm, or leg.
If the patient is not throwing up, they may receive a drink that has antacid in it or pain medication.
Although the patient's pain may not go away completely, they have the right to be comfortable and should ask for pain medicine until they are made comfortable.

Is Surgery Necessary for Some Causes of Abdominal Pain in Adults?

Some types of abdominal pain require surgical treatment.

If the patient's pain comes from an infected internal organ, such as the appendix or gallbladder, hospitalization, observation, and possibly surgery are indicated.
Bowel obstruction sometimes requires surgery, depending on what is causing the obstruction, how much bowel is obstructed, and whether or not the obstruction is temporary.
If the patient's pain comes from a ruptured or perforated organ, such as the bowel or stomach, they will need immediate surgery and will be taken directly to an operating room.

Do I Need to Follow-up with My Doctor After Having Abdominal Pain?

If the person is allowed to go home after their evaluation, they may be given instructions about what they can and cannot eat and drink and which medications they may take. The person may be told to return to the emergency department if certain conditions develop.

If the person is given no specific instructions they should follow these recommendations:

As soon as you feel like eating, start with clear liquids.
If clear liquids cause no further pain or vomiting, progress to "bland" foods such as crackers, rice, bananas, applesauce, or toast.
If your symptoms don't return in a few days return to your normal diet.

Patients should return to the emergency department or doctor in the following situations.

The pain worsens or if the patient starts vomiting, has a high fever, or cannot urinate or move their bowels
Any symptom that worsens or is alarming
Abdominal symptoms are not better in 24 hours

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Can Abdominal Pain in Adults be Prevented?

If the cause of the pain determined a person should follow the instructions specific for the diagnosis.

If, for example, an ulcer causes the pain, the person must avoid nicotine, caffeine, and alcohol.
If it is caused by gallbladder disease, the person should avoid greasy, fatty, and fried foods.

What is the Outlook for an Adult with Abdominal Pain?

Overall, many types of pain go away without surgery and never determining the cause, and most people need only relief from their symptoms.

Medical causes of abdominal pain generally have a good outcome, but there are exceptions.

Surgical causes of abdominal pain have varying outcomes depending on the severity of the condition and the person's underlying medical condition.

If the patient has uncomplicated appendicitis requiring surgery or uncomplicated gallstones, they should recover from the surgery with no long-term problems.
If the patient has a ruptured appendix or infected gallbladder, recovery may take longer.
Abdominal pain from a perforated ulcer or blocked bowel may mean major surgery and a long recovery.

For problems with a major blood vessel, such as rupture or blood clot, the prognosis may be less poor.

In general, the older the person is and the more underlying conditions they have, the worse the outcome of a surgical intervention.
Reviewed on 5/16/2018

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.
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Abdominal Pain (Causes, Remedies, Treatment)

 

   Abdominal pain definition and facts

   What is abdominal pain?

   What causes abdominal pain?

   Signs, symptoms, locations, types, and severity of abdominal pain

   How is the cause of abdominal pain diagnosed?

   What exams and tests help diagnose the cause of abdominal pain?

   How does IBS (irritable bowel syndrome) cause abdominal pain?

   Foods, natural remedies, and OTC treatments for certain causes of abdominal pain

   Why can diagnosis of the cause of abdominal pain be difficult?

   What medications can be used to treat certain causes of abdominal pain?

   What lifestyle choices can I make to prevent abdominal pain?

   When should I call my doctor about abdominal pain?

 

A woman on her bed experiencing abdominal pain.

Abdominal pain definition and facts

 

   Readers Comments 58

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   Abdominal (belly) pain is pain or discomfort that is felt in the part of the trunk below the ribs and above the pelvis.

   It comes from organs within the abdomen or organs adjacent to the belly.

   It is caused by inflammation, distention of an organ, or by loss of the blood supply to an organ.

   In irritable bowel syndrome (IBS) it may be caused by contraction of the intestinal muscles or hyper-sensitivity to normal intestinal activities.

   Symptoms associated with it may include:

       Bloating

       Belching

       Gas (flatus, farting)

       Indigestion

       Discomfort in the upper left or right; middle; or lower left or right abdomen

       Constipation

       Diarrhea

       GERD (gastro-esophageal reflux disease)

       Heartburn

       Chest discomfort

       Pelvic discomfort

   The cause of abdominal pain is diagnosed on the basis of its characteristics, the physical examination, and testing. Occasionally, surgery is necessary for diagnosis.

   The medical diagnosis of the cause is challenging because the characteristics may be atypical, tests are not always abnormal, diseases causing pain may mimic each other, and the characteristics of the pain may change over time.

   Medical treatment depends upon the patient’s history of disease or other health conditions that may be the cause.

 

What is abdominal pain?

 

Abdominal pain is felt in the abdomen. The abdomen is an anatomical area that is bounded by the lower margin of the ribs and diaphragm above, the pelvic bone (pubic ramus) below, and the flanks on each side. Although pain can arise from the tissues of the abdominal wall that surround the abdominal cavity (such as the skin and muscles), the term abdominal pain generally is used to describe discomfort originating from organs within the abdominal cavity. Organs of the abdomen include the stomach, small intestine, colon, liver, gallbladder, spleen, and pancreas.

 

Technically, the lowermost portion of the area described previously, is the pelvis, which contains the urinary bladder and rectum, as well as the prostate gland in men, and the uterus, Fallopian tubes, and ovaries in women. Often, it can be difficult to know if lower abdominal pain is coming from the lower abdomen or pelvis (pelvic pain).

 

Occasionally, pain may be felt in the belly even though it is arising from organs that are close to, but not within, the abdominal cavity, for example, conditions of the lower lungs, the kidneys, and the uterus or ovaries. On the other hand, it also is possible for pain from organs within the belly to be felt outside of the it. For example, the pain of pancreatic inflammation may be felt in the back. These latter types of pain are described as "referred” because it does not originate in the location that it is felt. Rather, the cause is located away from where it is felt (i.e., it is referred to a different area).

 

Picture of the organs and glands in the abdomen.

 

Picture of the organs and glands in the abdomen

 

What causes abdominal pain?

 

   Read Doctor's View

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Abdominal pain is caused by inflammation of an organ (for example, appendicitis, diverticulitis, colitis), by stretching or distention of an organ (for example, obstruction of the intestine, blockage of a bile duct by gallstones, swelling of the liver with hepatitis), or by loss of the supply of blood to an organ (for example, ischemic colitis).

 

To complicate matters, however, abdominal pain also can occur without inflammation, distention or loss of blood supply. An important example of the latter is the irritable bowel syndrome (IBS). It is not clear what causes the belly pain in IBS, but it is believed to be due either to abnormal contractions of the intestinal muscles (for example, spasm) or abnormally sensitive nerves within the intestines that give rise to painful sensations inappropriately (visceral hyper-sensitivity). This often is referred to as functional pain because no recognizable specific abnormality to account for the cause of the pain has been found - at least not yet.

Quick GuideWhat's Causing Your Abdominal Pain?

What's Causing Your Abdominal Pain?

Abdominal Pain Causes

 

Abdominal pain is a common symptom, and most people have experienced some sort of abdominal pain (belly or stomach pain). Causes of more serious causes of abdominal pain include:

 

   Bloody stools

   Black tarry stools

   Dehydration

   Painful urination

   Lack of urination

   Abrupt cessation of bowel movements

   Dehydration

 

Learn more about abdominal pain causes »

A collage highlighting the locations of abdominal pain on a female model at various angles.

Signs, symptoms, locations, types, and severity of abdominal pain

 

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Doctors will ask you a variety of questions about your belly pain in order to help find the possible causes of it, for example:

How did the pain begin?

 

   If it comes on suddenly, this may suggest a problem with an organ within the belly; for example, the interruption of the supply of blood to the colon (ischemia) or obstruction of the bile duct by a gallstone (biliary colic).

 

Where is the pain located?

 

   Appendicitis typically causes discomfort in the middle of the abdomen, and then moves to the right lower abdomen, the usual location of the appendix.

   Diverticulitis typically causes discomfort in the left lower abdomen where most colonic diverticuli are located.

   Discomfort from the gallbladder (biliary colic or cholecystitis) typically is felt in the middle, upper abdomen or the right upper abdomen near where the gallbladder is located.

 

What is the type and pattern of the pain?

 

   Is it severe, crampy, steady; or does it wax and wane? Obstruction of the intestine initially causes waves of crampy pain due to contractions of the intestinal muscles and distention of the intestine. True cramp-like pain suggests vigorous contractions of the intestines.

   Obstruction of the bile ducts by gallstones typically causes steady (constant) upper belly pain that lasts between 30 minutes and several hours.

   Acute pancreatitis typically causes severe, unrelenting, steady pain in the upper abdomen and upper back.

   The pain of acute appendicitis initially may start near the umbilicus, but as the inflammation progresses, it moves to the right lower abdomen.

   The character of pain may change over time. For example, obstruction of the bile ducts sometimes progresses to inflammation of the gallbladder with or without infection (acute cholecystitis). When this happens, the characteristics change to those of inflammatory pain.

 

How long does the pain last?

 

   The discomfort of IBS typically waxes and wanes over months or years and may last for years or decades.

   Biliary colic lasts no more than several hours.

   The pain of pancreatitis lasts one or more days.

   The pain of acid-related diseases - gastroesophageal reflux disease (GERD) or duodenal ulcers - typically occurs over a period of weeks or months that is worse followed by periods of weeks or months during which it is better (periodically).

   Functional pain may show this same pattern of periodicity.

 

What makes the pain worse?

 

   Pain due to inflammation (appendicitis, diverticulitis, cholecystitis, and pancreatitis) typically is aggravated by sneezing, coughing or any jarring motion. Individuals with inflammation prefer to lie still.

   What health conditions make abdominal pain worse or better?

 

What relieves the pain?

 

   The pain of IBS and constipation often is relieved temporarily by bowel movements and may be associated with changes in bowel habit.

   Pain due to obstruction of the stomach or upper small intestine may be relieved temporarily by vomiting which reduces the distention that is caused by the obstruction.

   Eating or taking antacids may temporarily relieve ulcer pain from the stomach or duodenum because both food and antacids neutralize the acid that is responsible for irritating the ulcers and causing the pain.

   Pain that awakens a patient from sleep is more likely to be due to non-functional causes and is more significant.

   Other associated symptoms that accompany abdominal pain may suggest:

   Fever suggests inflammation or infection.

   Diarrhea or rectal bleeding suggests an intestinal cause.

   Fever and diarrhea suggest inflammation of the intestines that may be infectious or non-infectious.

   How is the cause of abdominal pain diagnosed?

   Doctors determine the cause of the pain by relying on:

   Its characteristics, physical signs, and other accompanying symptoms

   Findings on physical examination

   Medical laboratory, radiological, and endoscopic testing

   Surgery

 

How is the cause of abdominal pain diagnosed?

 

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Doctors determine the cause of the pain by relying on:

 

   Characteristics, physical signs, and other accompanying symptoms

   Findings on physical examination

   Laboratory, radiological, and endoscopic testing

   Surgery

 

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A doctor examines a small boy that is experiencing stomach and abdominal pain.

What exams and tests help diagnose the cause of abdominal pain?

Physical examination

 

Examining the patient will provide the doctor with additional clues to the cause of the pain. The doctor will determine:

 

   The presence of sounds coming from the intestines that occur when there is obstruction of the intestines,

   The presence of signs of inflammation (by special maneuvers during the examination),

   The location of any tenderness

   The presence of a mass within the abdomen that suggests a tumor, enlarged organ, or abscess (a collection of infected pus)

   The presence of blood in the stool that may signify an intestinal problem such as an ulcer, colon cancer, colitis, or ischemia.

 

For example:

 

   Finding tenderness and signs of inflammation in the left lower abdomen often means that diverticulitis is present, while finding a tender (inflamed) mass in the same area may mean that the inflammation has progressed and that an abscess has formed.

   Finding tenderness and signs of inflammation in the right lower abdomen often means that appendicitis is present, while finding a tender mass in the same area may mean that the inflammation has progressed and that an abscess has formed.

   Inflammation in the right lower abdomen, with or without a mass, also may be found in Crohn's disease. (Crohn's disease most commonly affects the last part of the small intestine, usually located in the right lower abdomen.)

   A mass without signs of inflammation may mean that a cancer is present.

 

While the health history and physical examination are vitally important in determining the cause of abdominal pain, other medical tests often are necessary to determine the cause.

Laboratory tests

 

Laboratory tests such as the complete blood count (CBC), liver enzymes, pancreatic enzymes (amylase and lipase), pregnancy test and urinalysis are frequently ordered.

 

   An elevated white count suggests inflammation or infection (as with appendicitis, pancreatitis, diverticulitis, or colitis).

   A low red blood cell count may indicate a bleed in the intestines.

   Amylase and lipase (enzymes produced by the pancreas) commonly are elevated in pancreatitis.

   Liver enzymes may be elevated with gallstone attacks or acute hepatitis.

   Blood in the urine suggests kidney stones.

   When there is diarrhea, white blood cells in the stool suggest intestinal inflammation or infection.

   A positive pregnancy test may indicate an ectopic pregnancy (a pregnancy in the fallopian tube instead of the uterus).

 

Plain X-rays of the abdomen

 

Plain X-rays of the abdomen also are referred to as a KUB (because they include the kidney, ureter, and bladder). The KUB may show enlarged loops of intestines filled with copious amounts of fluid and air when there is intestinal obstruction. Patients with a perforated ulcer may have air escape from the stomach into the abdominal cavity. The escaped air often can be seen on a KUB on the underside of the diaphragm. Sometimes a KUB may reveal a calcified kidney stone that has passed into the ureter and resulted in referred abdominal pain or calcifications in the pancreas that suggest chronic pancreatitis.

Radiographic studies

 

   Ultrasound is useful in diagnosing gallstones, cholecystitis appendicitis, or ruptured ovarian cysts as the cause of the pain.

   Computerized tomography (CT) of the abdomen is useful in diagnosing pancreatitis, pancreatic cancer, appendicitis, and diverticulitis, as well as in diagnosing abscesses in the abdomen. Special CT scans of the abdominal blood vessels can detect diseases of the arteries that block the flow of blood to the abdominal organs.

   Magnetic resonance imaging (MRI) is useful in diagnosing many of the same conditions as CT tomography.

   Barium X-rays of the stomach and the intestines (upper gastrointestinal series or UGI with a small bowel follow-through) can be helpful in diagnosing ulcers, inflammation, and blockage in the intestines.

   Computerized tomography (CT) of the small intestine can be helpful in diagnosing diseases in the small bowel such as Crohn's disease.

   Capsule enteroscopy, uses a small camera the size of a pill swallowed by the patient, which can take pictures of the entire small bowel and transmit the pictures onto a portable receiver. The small bowel images can be downloaded from the receiver onto a computer to be inspected by a doctor later. Capsule enteroscopy can be helpful in diagnosing Crohn's disease, small bowel tumors, and bleeding lesions not seen on x-rays or CT scans.

 

Endoscopic procedures

 

   Esophagogastroduodenoscopy or EGD is useful for detecting ulcers, gastritis (inflammation of the stomach), or stomach cancer.

   Colonoscopy or flexible sigmoidoscopy is useful for diagnosing infectious colitis, ulcerative colitis, or colon cancer.

   Endoscopic ultrasound (EUS) is useful for diagnosing pancreatic cancer or gallstones if the standard ultrasound or CT or MRI scans fail to detect them.

   Balloon enteroscopy, the newest technique allows endoscopes to be passed through the mouth or anus and into the small intestine where small intestinal causes of pain or bleeding can be diagnosed, biopsied, and treated.

 

Surgery. Sometimes, diagnosis requires examination of the abdominal cavity either by laparoscopy or surgery.

Abdominal Pain: Causes, Symptoms and Diagnosis

 

Abdominal Pain Slideshow Pictures

Pelvic Pain:What's Causing Your Pelvic Pain?

 

Pelvic Pain Pictures Slideshow

Appendicitis Symptoms & Appendectomy Surgery

 

Appendicitis & Appendectomy Slideshow Pictures

An illustration of a constipated colon which is associated with irritable bowel syndrome (IBS).

How does IBS (irritable bowel syndrome) cause abdominal pain?

 

As previously mentioned, the discomfort of irritable bowel syndrome is due either to abnormal intestinal muscle contractions or visceral hypersensitivity. Generally, abnormal muscle contractions and visceral hypersensitivity are much more difficult to diagnose than other diseases or other health conditions, particularly since there are no typical abnormalities on physical examination or the usual diagnostic tests. The diagnosis is based on the history (typical symptoms) and the absence of other cause.

Foods, natural remedies, and OTC treatments for certain causes of abdominal pain

 

If you aren’t sure if you need to seek medical advice for belly pain, contact your doctor or other health care professional before using any home remedies.

 

Common home remedies and over-the-counter (OTC) medicines include:

 

   Eat less food

   Take small amounts of baking soda

   Use lemon and/or lime juice

   Start a BRAT diet (banana, rice, applesauce and toast) for a day or so for symptom relief.

   Don’t smoke or drink alcohol.

 

Some health care professionals recommend:

 

   Taking ginger

   Peppermint

   Licorice

   Chamomile tea

   Medications such as bismuth subsalicylate (Pepto-Bismol), loperamide (Imodium), ranitidine (Zantac) and other over-the-counter substances

 

Some of these may help reduce symptoms, but if symptoms persist, seek medical care. Beware of "cures" advertised as a single treatment that can cure all causes of this problem because no such remedy or cure exists.

 

Taking aspirin or NSAIDs should be avoided until the cause of the pain is diagnosed because the medications could make some causes worse (for example, peptic ulcers, intestinal bleeding).

Why can diagnosis of the cause of abdominal pain be difficult?

 

Modern advances in technology have greatly improved the accuracy, speed, and ease of establishing the cause of belly pain, but significant challenges remain. There are many reasons why diagnosing the cause of it can be difficult.

Symptoms may be atypical

 

   For example, the pain of appendicitis sometimes is located in the right upper abdomen, and of diverticulitis on the right side. Elderly patients and those taking corticosteroids may have little or no pain and tenderness when there is inflammation, for example, with cholecystitis or diverticulitis. This occurs because corticosteroids reduce the inflammation.

 

Tests are not always abnormal.

 

   Ultrasound examinations can miss gallstones, particularly small ones.

   CT scans may fail to show pancreatic cancer, particularly small ones.

   The KUB can miss the signs of intestinal obstruction or stomach perforation.

   Ultrasounds and CT scans may fail to demonstrate appendicitis or even abscesses, particularly if the abscesses are small.

   The CBC and other blood tests may be normal despite severe infection or inflammation, particularly in individuals receiving corticosteroids or other drugs that suppress the immune system.

 

Diseases can mimic one another.

 

   IBS symptoms can mimic bowel obstruction, cancer, ulcer, gallbladder attacks, or even appendicitis.

   Crohn's disease can mimic appendicitis.

   Infection of the right kidney can mimic acute cholecystitis.

   A ruptured right ovarian cyst can mimic appendicitis; while a ruptured left ovarian cyst can mimic diverticulitis.

   Kidney stones can mimic appendicitis or diverticulitis.

 

The characteristics of the pain may change.

 

   Examples discussed previously include the extension of the inflammation of pancreatitis to involve the entire abdomen and the progression of biliary colic to cholecystitis.

 

A close up of a doctor holding a bottle of pills and writing a prescription.

What medications can be used to treat certain causes of abdominal pain?

 

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Medications that are used for the treatment of underlying cause(s) of the pain are the medications of choice. For example, medications are not needed for the treatment of simple viral gastroenteritis (stomach flu or stomach bug), while surgery and/or chemotherapy may be the best approach to treat certain cancers in the abdomen. Other causes may require antispasmodics, antimicrobials, H2 blockers, or even nitrates or morphine. The diagnosed cause usually narrows the choice of medications. A few causes can only be treated by surgery (for example incarcerated hernia, abdominal adhesions from previous surgeries, and certain abdominal injuries), although some medications may be used (for example, morphine) while the person is waiting to have surgery.

What lifestyle choices can I make to prevent abdominal pain?

 

Lifestyle changes really depend on the cause of the pain.

 

   Eat a healthy diet, exercise, and avoid smoking and excess alcohol consumption to reduce the chances that you will experience certain causes.

   Good hygiene, especially hand washing and avoiding materials and foods contaminated with viruses and bacteria will reduce your chances of developing illness from many infectious causes.

 

When should I call my doctor about abdominal pain?

 

Some doctors suggest that if you have a "less serious" cause of abdominal pain you likely won’t need to see a doctor if the symptoms resolve in about 24 to 48 hours. For example, if you have viral or bacterial food poisoning, have had discomfort, but aren’t dehydrated.

 

If you have a chronic problem that occasionally causes abdominal discomfort, most doctors suggest you contact the person treating you for the ailment for an appointment or prescription (refill). However, if you have any of the problems or symptoms listed in the "serious abdominal pain "section above, you should seek immediate medical care.

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Medically Reviewed on 11/10/2017

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   Get the facts on the most common causes of abdominal pain. Learn the difference between a stomachache and more serious causes of abdominal pain. Diagnosis of abdominal pain is based on symptoms and the location of pain, like sharp pain in the lower abdomen.

   Colonoscopy

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   Colorectal cancer (colon cancer) is the cause of many cancer deaths. Learn about the warning signs, symptoms, screening process, stages, and treatment related to colorectal cancer.

   Complete Blood Count

   A complete blood count (CBC) is a calculation of the cellular makeup of blood. A CBC measures:

       the concentration of white blood cells, red blood cells, platelets in the blood, and aids in diagnosing conditions and disease such as

           malignancy, anemia, or blood clotting problems.

   Diarrhea

   Diarrhea is a change is the frequency and looseness of bowel movements. Symptoms associated with diarrhea are cramping, abdominal pain, and the sensation of rectal urgency. Causes of diarrhea include viral, bacterial, or parasite infection, gastroenteritis, food poisoning, and drugs. Absorbents and anti-motility medications are used to treat diarrhea.

   Endometriosis

 

   Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They also can be found in the vagina, cervix, and bladder. Endometriosis may not produce any symptoms, but when it does the most common symptom is pelvic pain that worsens just prior to menstruation and improves at the end of the menstrual period. Other symptoms of endometriosis include pain during sex, pain with pelvic examinations, cramping or pain during bowel movements or urination, and  infertility.

 

   Treatment of endometriosis can be with medication or surgery.

   Endoscopy

   Endoscopy is a broad term used to described examining the inside of the body using an lighted, flexible instrument called an endoscope. Endoscopy procedure is performed on a patient to examine the esophagus, stomach, and duodenum; and look for causes of symptoms such as:

       abdominal pain, nausea, vomiting, difficulty swallowing, or intestinal bleeding.

   Gastroenteritis (Stomach Flu)

 

   Stomach flu (gastroenteritis) is a term referred used to describe a variety of gastrointestinal problems. The most common signs and symptoms of gastroenteritis are nausea, vomiting, diarrhea, and abdominal pain.

 

   The most common cause of gastroenteritis in the United States is Norovirus. Other causes of gastroenteritis include Rotavirus, Astrovirus, Adenovirus, and Sapovirus. There are bacterial causes of gastroenteritis such as Salmonella, Shigella, Campylobacter Aeromonas, E. coli, Clostridium, Vibrio, Campylobacter, and Yersinia spp. Parasites that cause gastroenteritis include Giardia, Cryptosporidium, Cyclospora, and Entamoeba. Treatment for gastroenteritis is generally home remedies such as keeping hydrated to prevent dehydration. At times, hospitalization may be necessary if dehydration occurs.

   Hernia Overview

   A hernia occurs when an organ or piece of tissue protrudes from the space in which it is normally contained. Symptoms of a hernia include pain, nausea, vomiting, bowel obstruction, and fever. Hernias are diagnosed by a physical exam and imaging tests. Some hernias may be held in place with a supportive belt. Other hernias require surgical repair. The prognosis of people who undergo elective hernia repair tends to be good.

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Abdominal Pain: What You Should Know

In this Article

 

   What Are the Most Common Causes of Abdominal Pain?

   When Should You Contact Your Doctor?

   How Does Your Doctor Figure Out the Cause of Your Abdominal Pain?

 

Just about everybody at one time or another will get a bellyache. Most causes of abdominal pain aren't worrisome, and your doctor can easily diagnose and treat the problem. Sometimes, though, it can be a sign of a serious illness. Learn which symptoms to watch out for and when you should get medical help.

What Are the Most Common Causes of Abdominal Pain?

 

Whether you've got a mild stomachache, sharp pain, or cramps, abdominal pain can have many causes. For instance, you might have indigestion, constipation, a stomach virus, or, if you're a woman, menstrual cramps.

 

Other possible causes include:

 

   Irritable bowel syndrome (IBS)

   Crohn's disease

   Food poisoning

   Food allergies

   Gas

 

You may also get abdominal pain if you're lactose intolerant or have ulcers or pelvic inflammatory disease. Some other causes include:

 

   Hernia

   Gallstones

   Kidney stones

   Endometriosis

   Gastroesophageal reflux disease (GERD)

   Appendicitis

 

When Should You Contact Your Doctor?

 

If your abdominal pain is severe, doesn't go away, or keeps coming back, talk to your doctor. Call 911 right away if your belly hurts because you had a recent injury there or if you have any chest pain.

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You should also contact her as soon as you can if you have symptoms along with the pain, such as:

 

   Fever

   Can't keep food down for more than 2 days

   Signs you're getting dehydrated

   Can't have a bowel movement, especially if you're also vomiting

   Pain when you pee, or you need to urinate often

 

Also call your doctor if:

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   Your belly is tender to the touch.

   Pain lasts more than a few hours.

 

You may also get symptoms that could be a sign of a problem inside your body that needs treatment as soon as possible. For example, get medical care right away if you have abdominal pain and you also:

 

   Vomit blood

   Notice bloody or black, tarry bowel movements

   Have trouble breathing

   Vomit constantly

   Have swelling in your belly

   Have yellow skin

   Are pregnant

 

How Does Your Doctor Figure Out the Cause of Your Abdominal Pain?

 

Since there are so many possible causes, your doctor will do a thorough physical exam. She'll also ask you some questions about your symptoms. She'll want to know what type of pain you have. For instance, is it a severe stabbing pain or a dull ache?

 

   12View All

 

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Abdominal pain

 

Find possible causes of abdominal pain based on specific factors. Check one or more factors on this page that apply to your symptom.

Pain is

 

   Burning

   Crampy

   Dull

   Gnawing

   Intense

   Intermittent or episodic

 

   Ongoing (chronic)

   Sharp

   Steady

   Sudden (acute)

   Worsening or progressing

 

Pain located in

 

   Abdomen but radiates to other parts of the body

   Lower abdomen

   Middle abdomen

 

   One or both sides

   Upper abdomen

 

Triggered or worsened by

 

   Coughing or other jarring movements

   Drinking alcohol

   Eating certain foods

 

   Menstrual cycle

   Stress

 

Relieved by

 

   Antacids

   Avoiding certain foods

   Changing position

 

   Drinking more water

   Eating certain foods

   Eating more fiber

 

Accompanied by

 

   Abdominal swelling

   Black or bloody stools

   Constipation

   Diarrhea

   Fever

   Inability to move bowels in spite of urge

   Loose, watery stools

 

   Nausea or vomiting

   Passing gas

   Pulsing sensation near the navel

   Rash

   Stomach growling or rumbling

   Unintended weight loss

   Urgent need to have a bowel movement

 

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Abdominal Pain (Adults)

Medical Author:

Jerry R. Balentine, DO, FACEP

Medical Editor:

Jay W. Marks, MD

 

Facts and Definition of Abdominal Pain in Adults

 

   Abdominal pain is the feeling of pain in a person's stomach, upper or lower abdomen, and can range in intensity from a mild stomach ache to severe acute pain.

   Causes of symptoms of abdominal pain vary and may include gallbladder disease, ulcers of the stomach, food poisoning, diverticulitis, appendicitis, cancers, gynecologic (for example, fibroids, cysts, sexually transmitted diseases - STDs), and vascular problems.

   Some women experience abdominal pain during pregnancy.

   Abdominal pain can be acute or chronic and include sharp pain as well as dull pain.

   The location of the abdominal pain may be in the upper right or left side (quadrant), lower right or left side, and upper, middle, and lower.

   The cause of abdominal pain is diagnosed by a combination of history (questions the doctor asks you about your problem), physical examination (examination by a doctor), and testing (for example, X-rays and blood tests).

   Treatment for abdominal pain depends upon the cause and may include anything from observation, medications, and procedures that include endoscopy, and surgery.

   The prognosis for abdominal pain depends on the cause and the promptness of medical care and diagnosis.

 

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Type and Location of the Abdominal Pain

 

The type and location of pain may help the doctor find the cause. The intensity and duration of pain must also be considered when making a diagnosis. A few general characteristics of abdominal pain are:

 

   What the pain feels like: Abdominal pain can be sharp, dull, stabbing, cramp-like, knifelike, twisting, or piercing. Many other types of pain are also possible.

   How long the pain lasts: Abdominal pain can be brief, lasting for a few minutes, or it may persist for several hours and longer. Sometimes abdominal pain comes on strongly for a while and then lessens in intensity for a while. Is the pain continuous or does it come and go?

   Events that trigger pain: The pain may be worsened or relieved by certain events, such as worse after meals, better with a bowel movement, better after vomiting, or worse when lying down. Do certain foods trigger the pain?

   Location of the pain - The location often will help your doctor diagnose the cause of the pain.

       Upper left abdominal pain: Enlarged spleen

       Upper right abdominal pain: Gallbladder disease, hepatitis

       Lower left abdominal pain: Diverticulitis, ovarian cysts, ovarian torsion

       Lower right abdominal pain: Appendicitis, right ovary problems

       Upper abdominal pain: Stomach ulcers, gastritis, pancreatitis

       Lower abdominal pain: Urinary tract infections, gynecologic problems like uterine fibroids and cancer

 

Abdominal Pain Causes and Location (Right, Left, Lower, Upper)

 

Abdominal pain is caused by

 

   inflammation (appendicitis, diverticulitis, colitis),

   by stretching or distention of an organ (for example, gallstones, hepatitis), or

   by loss of the supply of blood to an organ (for example, ischemic colitis).

 

Learn more about the causes of abdominal pain »

 

What are Symptoms of Abdominal Pain in Adults?

 

   Readers Comments 29

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Abdominal pain is a symptom. It may mean that the person has a medical problem that needs treatment.

 

Abdominal pain may go along with other symptoms. Keep track of your symptoms because this will help the doctor find the cause of your pain. Make a special note if there is sudden abdominal pain, severe abdominal pain after eating, or abdominal pain with diarrhea.

 

What Are the Causes of Abdominal Pain in Adults?

 

   Readers Comments 2

   Share Your Story

 

Many acute (short-duration) and chronic (long-duration) diseases cause abdominal pain.

 

The diseases that most people are concerned about having are gastritis, appendicitis, kidney stones, gallbladder pain disease, duodenal and gastric ulcers, infections, and pregnancy-associated problems since these are the most common. Doctors also are concerned about ruptured blood vessels, heart attacks, liver and pancreas inflammation, kidney stones, problems with the blood circulation to the intestine, diverticulitis, cancers, and other diseases.

 

Abdominal pain may not arise from the abdomen.

 

   Some heart attacks and pneumonias can cause abdominal pain, and even nausea.

   Diseases of the pelvis or groin can also cause abdominal pain in adults.

   Testicular problems often can cause lower abdominal pain.

   Certain skin rashes, such as shingles, can feel like abdominal pain, even though the person has nothing wrong inside their body.

   Even some poisonings and bites, such as a black widow spider bite, can cause severe abdominal pain.

 

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What are Some of the Causes of Abdominal Pain by Location?

 

Abdominal pain can occur in any area of the abdomen. You might experience pain in one area of the abdomen although the cause for the pain is in a different area. Some diseases can cause pain in multiple areas of the abdomen. Below are the usual pain patterns associated with diseases, but please note that this does not include all diseases and conditions, and the below do not hold true all of the time.

Pain in the Upper Abdomen

 

   Stomach Ulcers

   Gastritis

   Pancreatitis

 

Pain in the Upper Right Side

 

   Gallbladder Disease

   Liver Inflammation (Hepatitis)

 

Pain in the Upper Left Side

 

   Enlarged Spleen

 

Pain in the Lower Right Side

 

   Other diseases and conditions of the uterus

   Appendicitis

   Right Ovarian Inflammation or Torsion

   Right Ovarian Cyst

 

Pain in the Lower Left Side

 

   Diverticulitis

   Left Ovarian Inflammation or Torsion

   Left Ovarian Cyst

 

Pain in the Lower Abdomen

 

   Urinary tract infections (UTI)

   Fibroids

 

From the above it is apparent that abdominal pain can have many causes, some linked directly to the abdomen and others caused by non-abdominal disease. Sometimes the cause of abdominal pain is not determined, and the you may be asked to return the next day to recheck and you perhaps need more tests. In some cases, no specific cause is determined, and the pain gets better in hours or days.

 

When Should an Adult Seek Medical Care for Abdominal Pain?

 

Call or see a doctor if the affected person has any of the following:

 

   Abdominal pain that lasts more than six hours or continues to worsen

   Severe abdominal pain

   Abdominal pain after eating

   Pain that stops a person from eating

   Pain accompanied by vomiting more than three or four times

   Abdominal pain during pregnancy

   Pain that worsens when a person tries to move around

   Pain that starts all over, but settles into one area, especially the right lower abdomen

   Pain that awakens a person up at night

   Pain with vaginal bleeding or pregnancy, even if a female only thinks she might be pregnant

   Pain accompanied by fever over 101 F (38.3 C)

   Pain along with inability to urinate, move the bowels, or pass gas

   Any other pain that feels different from a simple stomach ache

   Any other pain that alarms a person, or concerns them in any way

 

If the person has any of the following, or cannot reach their doctor, go to a hospital emergency department:

 

   Very severe pain

   Pain so bad the affected person passes out or almost passes out

   Pain so bad the affected person cannot move

   Pain and vomiting blood, or any vomiting that lasts more than six hours

   Pain and no bowel movement for more than three days

   Pain the person thinks might be in their chest, but they aren't sure

   Pain that seems to come from the person's testicles

 

What Kind of Doctor Treats Abdominal Pain in Adults?

 

Abdominal pain can be treated by a variety of doctors depending on the cause of the pain. It is usually best to start off with a primary care physician who can start the process of diagnosing the origin of the pain. Depending on the final diagnosis you will be treated by a primary care doctor (i.e. ulcers, infection) or referred to a surgeon (appendicitis, ovarian torsion), gastroenterologist, or gynecologist. If the pain is severe you might end up in the emergency department where an emergency medicine physician will be the first one to take care of you.

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What Questions will the Doctor ask about my Abdominal Pain?

 

Diagnosing the cause of abdominal pain is one of the hardest tasks for a doctor. Sometimes all that the professional can do is be sure that the pain does not require surgery or admission to the hospital.

 

The healthcare professional may ask these or similar questions to try to determine what is causing the patient's pain. Some may seem unrelated to the patient's current condition, but it is important to try to answer them as completely as possible. The answers to these questions can help the healthcare professional find the cause of the patient's pain more quickly and easily.

 

   How long have you had the pain?

   What were you doing when it started?

   How did you feel before the pain started?

   Have you felt OK over the last few days?

   What have you tried to make the pain better? Did it work?

   What makes the pain worse?

   Where is the pain located?

       Right side?

       Left side?

   Does the pain make you want to stay in one place or move around?

   How was the ride to the hospital? Did riding in the car hurt you?

   Is the pain worse when you cough?

   Have you thrown up?

   Did throwing up make the pain better or worse?

   Have your bowel movements been normal?

   When was your last bowel movement?

   Are you passing gas?

   Do you feel you might have a fever?

   Have you had a pain like this before? When? What did you do for it?

   Have you ever had surgery? What surgery? When?

   Are you pregnant? Are you sexually active? Are you using birth control?

   Have you been around anyone with symptoms like this?

   Have you traveled out of the country recently?

   When did you eat last? What did you eat?

   Did you eat anything out of the ordinary?

   Did your pain start all over your stomach and move to one place?

   Does the pain go into your chest? Into your back? Where does it go?

   Can you cover the pain with the palm of your hand, or is the hurting area bigger than that?

   Does it hurt to breathe?

   Do you have any medical problems such as heart disease, diabetes, or AIDS?

   Do you take steroids? Pain medicine such as aspirin or Motrin?

   Do you take antibiotics? Over-the-counter pills, herbs, or supplements?

   Do you drink alcohol? Coffee? Tea?

   Do you smoke cigarettes?

   Of course, the doctor may not need to ask all if these questions or may need to ask additional questions depending on the symptoms.

 

How Is the Cause of the Abdominal Pain Diagnosed?

 

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Physical Examination

 

Physical examination will include a careful examination of the patient's abdomen, heart, and lungs in order to pinpoint the source of the pain.

 

   The doctor will touch different parts of the abdomen to check for tenderness or other signs that indicate the source of the pain.

   The doctor may do a rectal exam to check for small amounts of blood in the stool or other problems, such as a mass or internal hemorrhoids.

   If the patient is a man, the doctor may check the penis and testicles.

   If the patient is a woman, the doctor may do a pelvic exam to check for problems in the uterus, Fallopian tubes, and ovaries.

   The doctor also may look at the patient's eyes for yellow discoloration (jaundice) and in the mouth to be sure the patient is not dehydrated.

 

Laboratory Tests

 

Laboratory tests may or may not help to determine the cause of the abdominal pain. Combined with the information gained from the questions the patient was asked and the physical examination performed by the doctor, certain blood or urine tests may be ordered and could assist in determining the diagnosis.

 

   One of the most important tests is to see if a woman is pregnant.

   A raised white blood cell count may mean infection or may just be a reaction to the stress of pain and vomiting.

   A low red blood count (hemoglobin) may mean that a patient is bleeding internally, but most conditions that involve bleeding are not painful.

   Blood in the urine, which may not be visible to the eye, suggests that a patient may have a kidney stone.

   Other blood tests, such as liver enzymes and pancreas enzymes, can help determine which organ is the cause of the pain, but they do not point to a diagnosis.

 

Radiology Tests

 

Radiology studies of the patient's abdomen can be useful, but are not always necessary or helpful.

 

   Occasionally, an X-ray will show air outside of the bowel, meaning that something has ruptured or perforated.

   An X-ray also can help diagnose bowel obstruction.

   Sometimes X-rays can show a kidney stone.

 

Ultrasound is a painless procedure useful in finding some causes of abdominal pain.

 

   This may be done if the doctor suspects problems with the gallbladder, pancreas, liver, or the reproductive organs of women.

   Ultrasound also assists in the diagnosis of problems with the kidneys and the spleen, or the large blood vessels that come from the heart and supplies blood to the lower half of the body.

 

Computerized tomography (CT scan) provides useful information about the liver, pancreas, kidneys and ureters, spleen, and small and large intestine.

 

The patient and doctor should discuss the need for an X-ray or CT scan and their associated radiation exposure before proceeding with any radiological examination.

 

MRI is usually less helpful than a CT scan when the abdomen is examined, although with certain problems and symptoms your healthcare professional may order an MRI rather than a CT scan or in follow up to any of the above examinations.

 

The doctor may perform no tests at all. The cause of the patient's pain may be clear without any tests and may be known not to be serious. If the patient does undergo tests, the professional should explain the reason for the test and any contraindications. When the results are available, the professional should discuss them with the patient, as well as whether the results impact the treatment.

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What Home Remedies Soothe Abdominal Pain in Adults?

 

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Abdominal pain without fever, vomiting, vaginal bleeding, passing out, chest pain, or other serious symptoms often get better without special treatment.

 

   If the pain persists or if a person believes the pain may represent a serious problem, they should see a doctor.

   A heating pad or soaking in a tub of warm water may ease pain.

   Over-the-counter (OTC) antacids, such as Tums, Maalox, or Pepto-Bismol, also can reduce some types of abdominal pain. Activated charcoal capsules also may help.

   Acetaminophen (common brand names are Arthritis Foundation Pain Reliever, Aspirin Free Anacin, Panadol, Tylenol) may help. This product should be avoided if liver disease is suspected. Patients should try to avoid aspirin or ibuprofen (common brand names are Advil, Motrin, Nuprin, Pamprin IB) stomach or intestinal ulcer disease is suspected; these drugs can make the pain worse.

 

What is the Medical Treatment for Causes of Abdominal Pain in Adults?

 

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The patient's treatment will depend on what the doctor thinks is causing the abdominal pain.

 

The patient may be given IV (intravenous) fluids. The doctor may ask the patient not to eat or drink anything until the cause of the pain is known. This is done to avoid worsening certain medical conditions (for example adding food to the stomach if there is a ruptured ulcer) or to prepare the patient in case they need to have surgery. (An empty stomach is better when general anesthesia is needed.)

 

The patient may be given pain medication.

 

   For pain caused by bowel spasm, they may be given a shot in the hip, arm, or leg.

   If the patient is not throwing up, they may receive a drink that has antacid in it or pain medication.

   Although the patient's pain may not go away completely, they have the right to be comfortable and should ask for pain medicine until they are made comfortable.

 

Is Surgery Necessary for Some Causes of Abdominal Pain in Adults?

 

Some types of abdominal pain require surgical treatment.

 

   If the patient's pain comes from an infected internal organ, such as the appendix or gallbladder, hospitalization, observation, and possibly surgery are indicated.

   Bowel obstruction sometimes requires surgery, depending on what is causing the obstruction, how much bowel is obstructed, and whether or not the obstruction is temporary.

   If the patient's pain comes from a ruptured or perforated organ, such as the bowel or stomach, they will need immediate surgery and will be taken directly to an operating room.

 

Do I Need to Follow-up with My Doctor After Having Abdominal Pain?

 

If the person is allowed to go home after their evaluation, they may be given instructions about what they can and cannot eat and drink and which medications they may take. The person may be told to return to the emergency department if certain conditions develop.

 

If the person is given no specific instructions they should follow these recommendations:

 

   As soon as you feel like eating, start with clear liquids.

   If clear liquids cause no further pain or vomiting, progress to "bland" foods such as crackers, rice, bananas, applesauce, or toast.

   If your symptoms don't return in a few days return to your normal diet.

 

Patients should return to the emergency department or doctor in the following situations.

 

   The pain worsens or if the patient starts vomiting, has a high fever, or cannot urinate or move their bowels

   Any symptom that worsens or is alarming

   Abdominal symptoms are not better in 24 hours

 

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Can Abdominal Pain in Adults be Prevented?

 

If the cause of the pain determined a person should follow the instructions specific for the diagnosis.

 

   If, for example, an ulcer causes the pain, the person must avoid nicotine, caffeine, and alcohol.

   If it is caused by gallbladder disease, the person should avoid greasy, fatty, and fried foods.

 

What is the Outlook for an Adult with Abdominal Pain?

 

Overall, many types of pain go away without surgery and never determining the cause, and most people need only relief from their symptoms.

 

Medical causes of abdominal pain generally have a good outcome, but there are exceptions.

 

Surgical causes of abdominal pain have varying outcomes depending on the severity of the condition and the person's underlying medical condition.

 

   If the patient has uncomplicated appendicitis requiring surgery or uncomplicated gallstones, they should recover from the surgery with no long-term problems.

   If the patient has a ruptured appendix or infected gallbladder, recovery may take longer.

   Abdominal pain from a perforated ulcer or blocked bowel may mean major surgery and a long recovery.

 

For problems with a major blood vessel, such as rupture or blood clot, the prognosis may be less poor.

 

In general, the older the person is and the more underlying conditions they have, the worse the outcome of a surgical intervention.

Reviewed on 5/16/2018

 

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

 

REFERENCE:

 

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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What is Diabetes?

Diabetes can strike anyone, from any walk of life.

And it does ñ in numbers that are dramatically increasing. In the last decade, the cases of people living with diabetes jumped almost 50 percent ñ to more than 30 million Americans. Worldwide, it afflicts more than 422 million people.

Diabets is a leading cause of blindness, kidney failure, amputations, heart failure and stroke.

Living with diabetes places an enormous emotional, physical and financial burden on the entire family. Annually, diabetes costs the American public more than $245 billion.

Just what is diabetes?

To answer that, you first need to understand the role of insulin in your body. When you eat, your body turns food into sugars, or glucose. At that point, your pancreas is supposed to release insulin. Insulin serves as a ìkeyî to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy.

But with diabetes, this system does not work.

Several major things can go wrong ñ causing the onset of diabetes. Type 1 and type 2 diabetes are the most common forms of the disease, but there are also other kinds, such as gestational diabetes, which occurs during pregnancy, as well as other forms.

Do you want to learn more about the basics of diabetes? Read our brochure: "What is Diabetes?" in English or "øQue es La Diabetes?" in Spanish.
What is Type 1 Diabetes?

The more severe form of diabetes is type 1, or insulin-dependent diabetes. Itís sometimes called ìjuvenileî diabetes, because type 1 diabetes usually develops in children and teenagers, though it can develop at any age.

What is diabetes? This illustration shows the pancreas and insulin, with insulin represented as the ëkeyí that ëopensí cells, allowing blood glucose to enter, and allowing body to use the glucose for energy
Immune System Attacks

With type 1 diabetes, the bodyís immune system attacks part of its own pancreas. Scientists are not sure why. But the immune system mistakenly sees the insulin-producing cells in the pancreas as foreign, and destroys them. This attack is known as "autoimmune" disease.

These cells ñ called ìisletsî (pronounced EYE-lets) ñ are the ones that sense glucose in the blood and, in response, produce the necessary amount of insulin to normalize blood sugars.

Insulin serves as a ìkeyî to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy. Without insulin, there is no ìkey.î So, the sugar stays -- and builds up-- in the blood. The result: the bodyís cells starve from the lack of glucose. And, if left untreated, the high level of ìblood sugarî can damage eyes, kidneys, nerves, and the heart, and can also lead to coma and death.
Insulin Therapy

So, a person with type 1 treats the disease by taking insulin injections. This outside source of insulin now serves as the ìkeyî -- bringing glucose to the bodyís cells.

The challenge with this treatment is that itís often not possible to know precisely how much insulin to take. The amount is based on many factors, including:

ïFood

ïExercise

ïStress

ïEmotions and general health
Balancing Act

These factors fluctuate greatly throughout every day. So, deciding on what dose of insulin to take is a complicated balancing act.

If you take too much, then your body burns too much glucose -- and your blood sugar can drop to a dangerously low level. This is a condition called hypoglycemia, which, if untreated, can be potentially life-threatening.

If you take too little insulin, your body can again be starved of the energy it needs, and your blood sugar can rise to a dangerously high level -- a condition called hyperglycemia. This also increases the chance of long-term complications.
What is Type 2 Diabetes?

The most common form of diabetes is called type 2, or non-insulin dependent diabetes.

This is also called ìadult onsetî diabetes, since it typically develops after age 35. However, a growing number of younger people are now developing type 2 diabetes.

People with type 2 are able to produce some of their own insulin. Often, itís not enough. And sometimes, the insulin will try to serve as the ìkeyî to open the bodyís cells, to allow the glucose to enter. But the key wonít work. The cells wonít open. This is called insulin resistance.

Often, type 2 is tied to people who are overweight, with a sedentary lifestyle.

Treatment focuses on diet and exercise. If blood sugar levels are still high, oral medications are used to help the body use its own insulin more efficiently. In some cases, insulin injections are necessary.

What is type 2 diabetes

Type 2 diabetes is a chronic condition that affects your bodyís use of glucose (a type of sugar you make from the carbohydrates you eat). Glucose is the fuel your cells need to do their work. You need glucose for energy. You also need insulin, a hormone produced by the pancreas that helps glucose enter your cells so that it can be converted to energy.

Hereís the problem: People with type 2 diabetes (also known as diabetes mellitus) canít properly use or store glucose, either because their cells resist it or, in some cases, they donít make enough. Over time, glucose builds up in the bloodstream, which can lead to serious health complications unless people take steps to manage their blood sugar.

Type 2 diabetes affects more than 29 million Americans, including nearly eight million who donít even know they have it. You may be at greater risk of developing type 2 diabetes if it runs in your family, if you are of a certain age or ethnicity, or if you are inactive or overweight.

Type 2 diabetes vs. type 1 diabetes

Whatís the difference between type 1 and type 2 diabetes?

Type 1 diabetes is an autoimmune disease in which the body does not produce insulin. The immune system destroys insulin-producing cells in the pancreas. Type 1 diabetes is usually diagnosed in children, teens, and young adults. People with type 1 diabetes need life-long insulin therapy.

Type 2 diabetes is much more common. In type 2 diabetes, the body doesnít use insulin properly or, in some cases, doesnít make enough. Itís usually diagnosed in middle-aged or older adults, but anyone can develop type 2 diabetes. It can be managed through diet, exercise, and medication.

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What causes type 2 diabetes?

Type 2 diabetes occurs when the body doesnít use insulin as it should or when the pancreas doesnít make enough insulin to ferry glucose out of the bloodstream and into the cells. Instead, the glucose builds up in the blood, resulting in high blood sugar.

When your body canít use insulin properly, itís called insulin resistance. Insulin resistance is responsible for most cases of type 2 diabetes. Scientists donít know why cells in the body become resistant to insulin, but itís clear that certain genetic and lifestyle factors play a role. Here are the most common:

Your genes. Type 2 diabetes tends to run in families. Scientists havenít pinpointed the gene or genes responsible for insulin resistance. But even if you inherit certain genes that amp up your risk, it doesnít mean you will go on to develop type 2 diabetes. How you live your life also affects your risk.
Your race. Certain racial groups, especially African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders have a higher risk of developing type 2 diabetes than white people.
Your lifestyle. Thereís nothing you can do about the genes you inherit. But you can control how you live. Being overweight is the main risk factor for developing insulin resistance, especially if you carry that extra weight around your waist. Being sedentary, smoking, drinking too much alcohol, and consuming a high-fat, low-fiber, sugar-laden diet can all increase your type 2 diabetes risk. You can reduce your risk by adopting healthier habits.
Your existing health concerns. Other medical issues that can increase your risk of developing type 2 diabetes include:
Having prediabetes. Prediabetes means having higher-than-normal blood glucose levels but not high enough to be diagnosed with type 2 diabetes. People with prediabetes who donít control their blood sugar can go on to develop type 2 diabetes.
Having gestational diabetes. Women who have gestational diabetes have elevated blood sugar levels during pregnancy and are at higher risk of developing type 2 diabetes later on. Moms should be tested six to 12 weeks after giving birth to screen for the condition.
Having another condition linked to type 2 diabetes. Polycystic ovary syndrome, for example, affects womenís sex hormones and is associated with an elevated diabetes risk, as is a history of heart disease or stroke.

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Type 2 diabetes symptoms

Type 2 diabetes can sneak up on you. Many people donít know they have it because symptoms usually develop slowly over time. But there are several signs of type 2 diabetes to watch for. Early indicators include increased urination, thirst, and hunger. Over time, excess sugar in the bloodstream can lead to other symptoms, including slow-to-heal wounds and frequent infections. If you develop any of these symptoms of type 2 diabetes, talk to your doctor.

Excessive urination. Running to the bathroom more often than usual or producing more urine than normal (including at night) can be one of the first signs of type 2 diabetes. Excessive urination, also called polyuria, occurs when blood sugar levels are too high. The kidneys have to work overtime to filter the excess sugar out of your blood, and some of it gets flushed out of the body in your urine.
Increased thirst. Excessive thirst, also called polydipsia, is another classic sign of type 2 diabetes. When your blood glucose is higher than normal, excess sugar spills into your urine, pulling water with it, and you have to urinate more frequently. You can become dehydrated from all that extra urination, so you then become thirsty, leading you to drink even moreñand urinate more.
Increased hunger. When you are insulin resistant or donít make enough insulin, glucose canít enter your cells. Starved for energy, you get hungrier than usual. Excessive hunger or increased appetite is also known as polyphagia.
Blurred vision. High blood sugar can cause the lens of the eye to swell, causing blurry vision. If your blood sugar levels fluctuate, you may notice at least a temporary improvement when sugar levels are closer to normal.
Unexplained weight loss. Sudden or unplanned weight loss can be a sign that your cells arenít getting glucose for energy. Without that sugar for fuel, your body begins burning fat and muscle instead, leading to weight loss.
Fatigue. When blood sugar is elevated, that fuel canít get to its destination. As a result, your energy lags, and you feel depleted. You may not be sleeping well, either, if you make frequent nighttime trips to the bathroom to empty your bladder.
Frequent infections. Yeast and bacteria thrive on sugar, so when blood glucose levels are abnormally high, thereís a greater risk for frequent or more severe yeast or urinary tract infections.
Slow-healing wounds. People with type 2 diabetes may find that it takes a long time for skin injuries to heal. Thatís because sugary blood is thicker and moves more slowly, especially through narrow blood vessels, meaning healing blood and oxygen takes longer to reach damaged tissue. Having open sores and wounds also boosts the risk for infections.
Dry, itchy skin. Everyone gets dry skin, but itchy feet, ankles, or legs could be signs of type 2 diabetes if you have other symptoms too. Fluid loss due to frequent urination plus poor circulation and nerve damage due to thick, sugary blood can dry out your skin, especially on your lower extremities.

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How is diabetes diagnosed?

Several tests may be used for diagnosing diabetes. A simple blood test known as a hemoglobin A1C (or glycated hemoglobin test) measures average blood glucose levels over the past three months. (Why three months? Because glucose attaches to a protein called hemoglobin in red blood cells, and those cells get recycled and replenished about every three months.)

A normal A1C is below 5.7%. A higher percentage reflects higher blood glucose levels. Prediabetes is defined as a reading of 5.7 to 6.4, while diabetes is diagnosed when glucose levels reach 6.5% or higher.

A fasting plasma glucose test measures blood glucose at a single point in time. Generally, this test is performed first thing in the morning before breakfast, after at least eight hours of fasting. A normal reading is less than 100 milligrams per deciliter (mg/dl). A reading of 100 to 125 mg/dl signals prediabetes, and a reading of 126 mg/dl or higher indicates diabetes.

An oral glucose tolerance test measures your bodyís ability to handle glucose. It is mostly used to diagnose gestational diabetes. First, blood is drawn after an overnight fast. Then you drink a special glucose solution, and your blood is drawn again two hours later. A normal reading at that time is 139 mg/dl or below. A reading of 140 to 199 mg/dl indicates prediabetes, while diabetes is diagnosed at 200 mg/dl or above.

A random or casual plasma glucose test may be performed any time you have diabetes symptoms. It doesnít require fasting. A reading of 200 mg/dl or above suggests diabetes.

These tests cannot distinguish between type 1 and type 2 diabetes. Generally, people with type 1 diabetes are diagnosed as children, teens, or young adults, while type 2 diabetes usually occurs in adults 45 and older. Type 1 diabetes is an autoimmune disease, so an autoantibody test may be done to help a doctor determine if you have type 1 or type 2 diabetes.

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Type 2 diabetes treatment

Type 2 diabetes is treated through diet, exercise, and medication. The goal of treatment is to keep blood sugar under control and stave off diabetes complications.

Some people manage through diet and exercise alone. Others need oral medicines, insulin, other injectable medications, or some combination of type 2 diabetes medñalong with healthy food and fitnessñto keep blood sugar in check.

There are lots of treatment options. What your doctor prescribes may depend on what other health conditions you have and how well certain medications work for you.

RELATED: 12 Myths About Insulin and Type 2 Diabetes

Diabetes treatment includes:

Metformin. This oral medication comes as a pill or liquid. Itís often the first medicine that people with type 2 diabetes take. Metformin improves your bodyís use of insulin and reduces the amount of glucose your liver makes.
Sulfonylureas. These pills stimulate the release of insulin by the pancreas and help the body use insulin better. Popular sulfonylureas include glimepiride (Amaryl), glipizide (Glucotrol), and glyburide (DiaBeta, Micronase, and Glynase).
Meglitinides. Much like sulfonylureas, this class of medicines boosts insulin production in the body. These oral meds, including repaglinide (Prandin) and nateglinide (Starlix), are fast acting and donít stay in the body for long, so they must be taken just before meals.
Thiazolidinediones. Also known as TZDs or glitazones, these oral medications work by lowering insulin resistance. This class includes pioglitazone (Actos) and rosiglitazone (Avandia).
Gliptins or DPP-4 inhibitors. This class of drugs improves the release of insulin in the body. One example is sitagliptin (Januvia).
SGLT2 inhibitors. These oral medicines help your kidneys remove sugar from the body through urine. The class includes canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin (Jardiance).
GLP-1 receptor agonists. Injectable drugs like exenatide (Byetta), liraglutide (Victoza), and dulaglutide (Trulicity) control blood sugar by slowing digestion, improving how insulin works in the body, and preventing the liver from releasing too much sugar into the bloodstream.
Insulin therapy. There are many different types of insulin. They vary by how soon they start to work, when they peak, and how long they last. Insulin comes in different strengths and has multiple delivery methodsñneedle, pen, pump, port, jet injector, and inhaler.
Bariatric surgery. Research suggests that weight-loss surgery can improve blood sugar control in some obese people with type 2 diabetes. Some people may no longer need diabetes medication after bariatric surgery, but these results tend to vary patient to patient.

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Can type 2 diabetes be cured or reversed?

No treatments can cure diabetes. But this chronic condition can be controlled, and sometimes symptoms even disappear for periods of time.

Remember, type 2 diabetes develops gradually as the cells in the body resist insulin or the pancreas fails to make enough of it. For a while, thereís enough insulin to get by. But, in time, the body can no longer convert glucose into energy, causing blood sugar levels to spike.

Type 2 diabetes treatments donít fix this problem. Thereís no type 2 diabetes cure. But medications can help people normalize their blood sugar, and gaining control over your blood sugar is crucial for preventing or reducing complications.

Left untreated, type 2 diabetes can wreak havoc, damaging the heart, blood vessels, nerves, kidneys, brain, eyes, feet, and skin. It increases the risk for heart attack and stroke. It can lead to kidney failure. People with type 2 diabetes can lose their vision. In some severe cases, people with type 2 diabetes need a foot or a leg amputated. The risk of these and other complications is why it is so important to keep your blood sugar under control.
Type 2 diabetes diet

A healthy diet can help people with type 2 diabetes shed excess weight and manage blood sugar. While thereís no one-size-fits-all meal plan for controlling type 2 diabetes, watching what and how much you eat can go a long way.

One option for your type 2 diabetes diet is to adopt a plant-based Mediterranean-style of eating, incorporating healthy oils, fish, fruits, vegetables, nuts, and beans.

Or ìCreate Your Plateî with the help of an online tool by the American Diabetes Association. Fill half of your plate with non-starchy vegetables, one quarter with protein and one quarter with grains or other starchy foods. Add a serving of fruit, dairy, or both, and use healthy fats in small amounts. Round out your meal with water or a low-calorie drink like unsweetened coffee or tea.

Some people learn to count carbohydrates, since carbs affect blood sugar more than protein and fat. Keeping track of daily carb consumption can help keep blood sugar levels within a normal range. A dietitian or diabetes counselor can help you learn to track grams of carbohydrate in the foods you eat.

RELATED: 20 Tasty Diabetes-Friendly Recipes

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Type 2 diabetes prevention

To prevent type 2 diabetes, take a close look at your health habits. Thereís a lot you can do to lower your risk, and even modest changes can help.

Eat healthy. To prevent weight gainña major risk factor for type 2 diabetesñeat more fruits and vegetables, cut back on sugary drinks and desserts, and watch your portion sizes.
Lose weight. If youíre overweight, dropping just 5% to 7% of your weight (thatís 10 to 14 pounds for a 200-pound person), and keeping that weight off, can prevent or delay type 2 diabetes.

RELATED: 10 Diet and Exercise Tricks to Control Diabetes

Get physical. The American Diabetes Association recommends a combination of aerobic exercise and strength training. Aim for 30 minutes of moderate to vigorous exercise, like brisk walking, swimming, cycling, or tennis, at least five days a week. Strength-training exercises build muscle mass, which helps you burn more calories, even when youíre at rest, so you can keep those pounds off.

Celebrities with type 2 diabetes

Actors, athletes, and musicians arenít immune to type 2 diabetes. While some famous folks with diabetes say the diagnosis came as a surprise, others were aware of risk factors they faced, like a family history of the disease. After making healthy changes, many chose to speak out about the dangers of type 2.

Actor Tom Hanks announced his type 2 diabetes diagnosis in 2013, revealing that his blood sugar levels had been high for years before he was diagnosed. Itís possible that his yo-yo dieting for rolesñhe gained 30 pounds to play Jimmy Dugan in A League of Their Own and later shed 50 to play Chuck Noland in Cast Awayñcould have increased his risk of blood sugar problems.

Celebrity chef Paula Deen, famous for dishes loaded with fat and calories, confirmed she had type 2 diabetes in 2012. A buttery diet alone will not necessarily cause diabetes, however; Deen spoke out about other risk factors that can play a role in the disease, like age, genes, and stress.

Tennis legend Billie Jean King was diagnosed with type 2 diabetes in 2007. After years of battling with her weight, she used the diagnosis as motivation to lose 35 pounds. Music producer Randy Jackson also lost weight after a type 2 diabetes diagnosis. With gastric bypass surgery, he shed almost 100 pounds and got his blood sugar under control.

Other notable stars with type 2 diabetes include self-proclaimed ìdivabeticî Patti Labelle, who was diagnosed after passing out on stage in 1994; actor Paul Sorvino, who experienced fatigue and increased thirst for months before he was diagnosed; and Dick Clark, who became a spokesperson for the American Association of Diabetes Educators 10 years after he himself was diagnosed.

What is Diabetes?

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesnít make enoughóor anyóinsulin or doesnít use insulin well. Glucose then stays in your blood and doesnít reach your cells.

Over time, having too much glucose in your blood can cause health problems. Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy.

Sometimes people call diabetes ìa touch of sugarî or ìborderline diabetes.î These terms suggest that someone doesnít really have diabetes or has a less serious case, but every case of diabetes is serious.
What are the different types of diabetes?

The most common types of diabetes are type 1, type 2, and gestational diabetes.
Type 1 diabetes

If you have type 1 diabetes, your body does not make insulin. Your immune system attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age. People with type 1 diabetes need to take insulin every day to stay alive.
Type 2 diabetes

If you have type 2 diabetes, your body does not make or use insulin well. You can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes occurs most often in middle-aged and older people. Type 2 is the most common type of diabetes.
Gestational diabetes

Gestational diabetes develops in some women when they are pregnant. Most of the time, this type of diabetes goes away after the baby is born. However, if youíve had gestational diabetes, you have a greater chance of developing type 2 diabetes later in life. Sometimes diabetes diagnosed during pregnancy is actually type 2 diabetes.
Other types of diabetes

Less common types include monogenic diabetes, which is an inherited form of diabetes, and cystic fibrosis-related diabetes .
How common is diabetes?

As of 2015, 30.3 million people in the United States, or 9.4 percent of the population, had diabetes. More than 1 in 4 of them didnít know they had the disease. Diabetes affects 1 in 4 people over the age of 65. About 90-95 percent of cases in adults are type 2 diabetes.1
Who is more likely to develop type 2 diabetes?

You are more likely to develop type 2 diabetes if you are age 45 or older, have a family history of diabetes, or are overweight. Physical inactivity, race, and certain health problems such as high blood pressure also affect your chance of developing type 2 diabetes. You are also more likely to develop type 2 diabetes if you have prediabetes or had gestational diabetes when you were pregnant. Learn more about risk factors for type 2 diabetes.
What health problems can people with diabetes develop?

Over time, high blood glucose leads to problems such as

heart disease
stroke
kidney disease
eye problems
dental disease
nerve damage
foot problems

You can take steps to lower your chances of developing these diabetes-related health problems.

How is Diabetes Treated?

The goals of diabetes treatment are to control your blood glucose levels and prevent diabetes complications. Your diabetes healthcare team will focus on these three areas to help you achieve optimum health:

Nutrition

When you have type 1 or type 2 diabetes, you need to be very aware of not only what you eat, but also when and how much you eat. A Certified Diabetes Educator (CDE) at Joslin can work with you to develop a healthy meal plan that fits your lifestyle. Following a meal plan can also help you lose weight and lower your risk of developing complications.

Physical Activity

Physical activity is an important part of controlling diabetes and preventing complications such as heart disease and high blood pressure. "We know that exercise is a very effective way to help bring blood sugars under control for someone with type 2 diabetes," says Kenneth Snow, M.D., Acting Chief, Adult Diabetes, Joslin Clinic. Try for 30 minutes of moderate exercise, like brisk walking, on most days. Joslin's Why WAIT? and Easy Start exercise programs are great resources for developing a safe weight loss program.

Medications

If you have type 2 diabetes, sometimes eating healthy and engaging in physical activity is not enough. Your doctor may give you oral medication to help control your blood glucose levels. For people with type 1 diabetes (and some people with type 2 diabetes) this means taking insulin. People with type 1 diabetes must take insulin to control diabetes--and this can only be done through multiple injections or by an insulin pump, a small device that delivers insulin continuously throughout the day. For more on medications and diabetes, click here.

How to Reverse Diabetes Naturally
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Reverse diabetes - Dr. Axe

According to the 2017 National Diabetes Statistics Report, over 30 million people living in the United States have diabetes. Thatís almost 10 percent of the U.S. population. And diabetes is the seventh leading cause of death in the United States, causing, at least in part, over 250,000 deaths in 2015. Thatís why itís so important to take steps to reverse diabetes and the diabetes epidemic in America.

Type 2 diabetes is a dangerous disease that can lead to many other health conditions when itís not managed properly, including kidney disease, blindness, leg and food amputations, nerve damage, and even death. (1)

Type 2 diabetes is a completely preventable and reversible condition, and with diet and lifestyle changes, you can greatly reduce your chances of getting the disease or reverse the condition if youíve already been diagnosed. If you are one of the millions of Americans struggling with diabetes symptoms, begin the steps to reverse diabetes naturally today. With my diabetic diet plan, suggested supplements and increased physical activity, you can quickly regain your health and reverse diabetes the natural way.
The Diabetes Epidemic

Diabetes has grown to ìepidemicî proportions, and the latest statistics revealed by the U.S. Centers for Disease Control and Prevention state that 30.3 million Americans have diabetes, including the 7.2 million people who werenít even aware of it. Diabetes is affecting people of all ages, including 132,000 children and adolescents younger than 18 years old. (2)

The prevalence of prediabetes is also on the rise, as itís estimated that almost 34 million U.S. adults were prediabetic in 2015. People with prediabetes have blood glucose levels that are above normal but below the defined threshold of diabetes. Without proper intervention, people with prediabetes are very likely to become type 2 diabetics within a decade.

Find out how I recommend you can reverse diabetes naturally in 30 days.

The cost of diabetes to our nation is a staggering $245 billion a year as of 2012. The American Diabetes Association reports that the average medical expenditure for people with diabetes was about $13,700 per year. People with diabetes typically have medical costs that are approximately 2.3 times higher than those without diabetes. (3)

Diabetes by the numbers - Dr. Axe

Aside from the financial costs of diabetes, the more frightening findings are the complications and co-existing conditions. In 2014, 7.2 million hospital discharges were reported with diabetes as a listed diagnosis. Patients with diabetes were treated for major cardiovascular diseases, ischemic heart disease, stroke, lower-extremity amputation and diabetic ketoacidosis.
The Cause of Diabetes

Diabetes is an illness related to elevated blood sugar levels. When you stop releasing and responding to normal amounts of insulin after eating foods with carbohydrates, sugar and fats, you have diabetes. Insulin, a hormone thatís broken down and transported to cells to be used as energy, is released by the pancreas to help with the storage of sugar and fats. But people with diabetes donít respond to insulin properly, which causes high blood sugar levels and diabetes symptoms.

Itís important to note that thereís a difference between type 1 and type 2 diabetes. Hereís an explanation of the two types of diabetes and what causes these conditions:

Type 1 Diabetes

Type 1 diabetes is commonly called ìjuvenile diabetesî because it tends to develop at a younger age, typically before a person turns 20 years old. Type 1 diabetes is an autoimmune disease where the immune system attacks the insulin-producing beta cells in the pancreas. The damage to the pancreatic cells leads to a reduced ability or complete inability to create insulin. Some of the common causes that trigger this autoimmune response may include a virus, genetically modified organisms, heavy metals, vaccines, or foods like wheat, cowís milk and soy. (4)

The reason foods like wheat and cowís milk have been linked to diabetes is because they contain the proteins gluten and A1 casein. These proteins can cause leaky gut, which in turn causes systemic inflammation throughout the body and over time can lead to autoimmune disease.

Type 1 diabetes is rarely reversed, but with the right dietary changes major improvements in blood sugar levels can be seen and a person can often reduce his or her dependence on insulin and medications.

Type 2 Diabetes
Type 2 diabetes is the most common form of diabetes, and unlike type 1 diabetes, it usually occurs in people over the age of 40, especially those who are overweight. Type 2 diabetes is caused by insulin resistance, which means that the hormone insulin is being released, but a person doesnít respond to it appropriately. Type 2 diabetes is a metabolic disorder thatís caused by high blood sugar. The body can keep up for a period of time by producing more insulin, but over time the insulin receptor sites burn out. Eventually, diabetes can affect nearly every system in the body, impacting your energy, digestion, weight, sleep, vision and more. (5)

There are many underlying causes of type 2 diabetes, and the disease usually develops because of a combination of factors, including: (6)

having a poor diet
being overweight
having high levels of inflammation
living a sedentary lifestyle
experiencing high amounts of stress
having a family history of diabetes (especially a parent or sibling)
having high blood pressure or a history of heart disease
having a hormonal condition (like hyperthyroidism, polycystic ovary syndrome or Cushingís syndrome)
being exposed to toxins, viruses or harmful chemicals
taking certain medications (like those that disrupt insulin production)

Thankfully, there are ways to reverse diabetes naturally.

draxe-Insulin Resistance infographic2

5-Step Plan to Reverse Diabetes
Step 1: Remove These Foods to Reverse Diabetes Naturally

Certain foods negatively affect your blood sugar levels, cause inflammation and trigger immune responses. To reverse diabetes naturally, the first step is to remove these foods from your diet:

Refined sugar: Refined sugar rapidly spikes blood glucose, and soda, fruit juice and other sugary beverages are the worst culprits. These forms of sugar enter the bloodstream rapidly and can cause extreme elevations in blood glucose. (7) Even though natural sweeteners like raw honey and maple syrup are better options, they can still affect blood sugar levels, so only use these foods on occasion. Your best option is to switch to stevia, a natural sweetener that wonít have as much of an impact.
Grains: Grains, especially gluten-containing grains like wheat, contain large amounts of carbohydrates that are broken down into sugar within only a few minutes of consumption. Gluten can cause intestinal inflammation, which affects hormones like cortisol and leptin, and can lead to spikes in blood sugar. I recommend removing all grains from your diet for 90 days as your body adjusts to this healing program. Then you can try bringing sprouted ancient grains back into your diet in small amounts.
Conventional cowís milk: Conventional cowís milk and dairy products should be eliminated, especially for people with type 1 diabetes. Dairy can be a fantastic food for balancing blood sugar if it comes from goatís, sheep or A2 cows. But stay away from all other forms of dairy because the A1 casein produced by conventional cows will harm the body and trigger an immune response similar to gluten. When buying dairy, only purchase raw and organic products from pasture-raised animals.
Alcohol: Alcohol can dangerously increase blood sugar and lead to liver toxicity. Research published in Annals of Internal Medicine found that there was a 43 percent increased incidence of diabetes associated with heavy consumption of alcohol, which is defined as three or more drinks per day. (8) Beer and sweet liquors are especially high in carbohydrates and should be avoided.
GMO foods: GMO corn, soy and canola have been linked to kidney and liver disease and may promote diabetes. I suggest removing all GMO foods and all packaged foods from your diet. Opt for products that are labeled organic or GMO-free.
Hydrogenated oils: Remove hydrogenated, rancid oils from your diet, including vegetable oil, soybean oil, cottonseed oil and canola oil. Because these oils are processed, treated at very high temperatures, and combined with bleaching agents and artificial dyes, consuming them has been linked to many health concerns, including diabetes.

Step 2: Incorporate These Foods to Treat Diabetes

To reverse or prevent type 2 diabetes, add the following foods into your diet:

Foods high in fiber: Research shows that 90 percent of the U.S. population doesnít consume enough fiber on a daily basis. High-fiber foods help slow down glucose absorption, regulate your blood sugar levels and support detoxification. Aim to eat at least 30 grams of fiber per day, which can come from vegetables (like Brussels sprouts, peas and artichokes), avocados, berries, nuts and seeds, especially chia seeds and flaxseeds. (9)
Foods high in chromium: Chromium is a nutrient thatís involved in normal carbohydrate and lipid metabolism. Foods high in chromium can improve the glucose tolerance factor in your body and naturally balance out blood glucose levels. It plays a role in insulin pathways, helping bring glucose into our cells so it can be used for bodily energy. Broccoli has the highest amounts of chromium, but you can also find it in raw cheese, green beans, brewerís yeast and grass-fed beef. (10)
Magnesium-rich foods: Magnesium can help regulate blood sugar levels because it plays a role in glucose metabolism. Research shows that diabetes is frequently associated with magnesium deficiency. Eating magnesium-rich foods, like spinach, chard, pumpkin seeds, almonds, yogurt and black beans, can improve type 2 diabetes symptoms. (11)
Healthy fats: Medium-chained fatty acids found in coconut and red palm oil can help balance blood sugar levels, and they serve as the preferred fuel source for your body rather than sugar. Using coconut milk, ghee and grass-fed butter can also help balance out your blood sugar levels, so include these foods into your meals and smoothies.
Clean protein: Eating protein foods has a minimal effect on your blood glucose levels, and it can slow down the absorption of sugar. Some of the best sources of clean protein include wild-caught fish, which contains omega-3 fats that reduce inflammation, grass-fed beef, organic chicken, lentils, eggs and bone broth.
Foods with a low glycemic load: The glycemic index of a food tells you about the blood glucose-raising potential of the food. Foods that have a high glycemic index are converted into sugar after being eaten more quickly than low glycemic foods. If you are fighting diabetes, stick to low glycemic foods like non-starchy vegetables, stone fruits and berries, nuts, seeds, avocados, coconut, organic meat, eggs, wild-caught fish, and raw pastured dairy.

One benefit of these foods is that they generally promote weight loss, which is a major factor in reversing diabetes. A study following 306 diabetic individuals found that losing weight under a structured program (with the supervision of a primary care physician) resulted in almost half of the participants going into total diabetes remission. This means they were able to stay off their medications permanently (assuming they stayed on a healthy diet). Quality of life also improved by over seven points on average for the patients on the dietary regimen, while it decreased by about three points for the control group. (12)
Step 3: Take These Supplements for Diabetes

1. Chromium Picolinate

Taking 200 micrograms of chromium picolinate three times daily with meals can help improve insulin sensitivity. A review published in Diabetes Technology and Therapeutics evaluated 13 studies that reported significant improvement in glycemic control and substantial reductions in hyperglycemia and hyperinsulinemia after patients used chromium picolinate supplementation. Other positive outcomes from supplementing with chromium picolinate included reduced cholesterol and triglyceride levels and reduced requirements for hypoglycemic medication. (13)

2. Cinnamon

Cinnamon has the ability to lower blood sugar levels and improve your sensitivity to insulin. A study conducted at Western University of Health Sciences in Pomona, Calif. found that the consumption of cinnamon is associated with a statistically significant decrease in plasma glucose levels, LDL cholesterol and triglyceride levels. Cinnamon consumption also helped increase HDL cholesterol levels. (14)

To take advantage of the many health benefits of cinnamon, add one teaspoon to food, smoothies or tea. You can also take one to two drops of cinnamon essential oil internally by adding it to food or tea, or combine three drops of cinnamon oil with half a teaspoon of coconut oil and massage it into your wrists and abdomen.

3. Fish Oil

Taking a fish oil supplement can help improve markers of diabetes by reducing triglyceride levels and raising HDL cholesterol levels. Research published in the Journal of Research in Medical Sciences shows that omega-3 fatty acids found in fish oil are necessary for proper insulin function, preventing insulin intolerance and reducing inflammation. (15) To use fish oil as a natural remedy for diabetes, take 1,000 milligrams daily.
4. Alpha Lipoic Acid

Alpha lipoic acid is an antioxidant that helps turn glucose into fuel for the body. It effectively improves insulin sensitivity and reduces symptoms of diabetic neuropathy, such as weakness, pain and numbness thatís caused by nerve damage. Although we make alpha lipoic acid and it can be found in some food sources, like broccoli, spinach and tomatoes, taking an ALA supplement will increase the amount that circulates in your body, which can be extremely beneficial when trying to reverse diabetes naturally. (16)
5. Bitter Melon Extract

Bitter melon helps lower blood glucose levels, and it regulates the bodyís use of insulin. Studies show that bitter melon extract can help reduce and manage symptoms of diabetes, including insulin resistance, heart complications, kidney damage, blood vessel damage, eye disorders and hormone irregularities. (17)
Step 4: Follow This Eating Plan to Reverse Diabetes

If you want to balance your blood sugar and see results quickly, then follow this diabetes eating plan as closely as possible. Focus on getting plenty of clean protein, healthy fats and fiber into every meal, which can help reverse diabetes.

Start by trying these first three days of the plan, and then use a combination of these foods going forward. Review the list of foods that you should be eating from Step 2, and bring those healthy, diabetes-fighting foods into your diet as well. It may seem like a major change to your diet at first, but after some time you will begin to notice the positive effects these foods are having on your body.

Diabetes meal plan - Dr. Axe

Some other recipes that fit into this eating plan include:

Eggs Benedict Recipe
Turkey-Stuffed Bell Peppers
Cucumber Salad Recipe
Buffalo Cauliflower

Step 5: Exercise to Balance Blood Sugar

Exercise reduces chronic disease and can help reverse diabetes naturally. Studies show that exercise improves blood glucose control and can prevent or delay type 2 diabetes, while also positively affecting your blood pressure, heart health, cholesterol levels and quality of life. (18)

Exercise naturally supports your metabolism by burning fat and building lean muscle. To prevent and reverse diabetes, make exercise a part of your daily routine. This doesnít necessary mean that you have to spend time at the gym. Simple forms of physical activity, like getting outside and walking for 20 to 30 minute every day, can be extremely beneficial, especially after meals. Practicing yoga or stretching at home or in a studio is another great option.

In addition to walking and stretching exercises, try interval training cardio, like burst training, or weight training three to five days a week for 20ñ40 minutes. Burst training can help you burn up to three times more body fat than traditional cardio and can naturally increase insulin sensitivity. You can do this on a spin bike with intervals, or you can try burst training at home.

Strength training using free weights or machines is also recommended because it helps you build and maintain muscle, which supports balanced blood sugar and sugar metabolism.
Final Thoughts on How to Reverse Diabetes

More than 30 million people ó nearly 10 percent of the population ó have diabetes in the U.S., including children. Almost 7.2 million of those people arenít even aware of it.
Another 34 million adults are prediabetic.
Itís the seventh leading cause of death in the U.S. and costs hundreds of billions of dollars per year.
Type 1 diabetes typically occurs before someone turns 20 and is rarely reversed, but it can be managed through diet and lifestyle changes.
Type 2 diabetes is more common and usually occurs in people over 40, especially if theyíre overweight.
In order to reverse diabetes naturally, remove foods like refined sugar, grains, conventional cowís milk, alcohol, GMO foods and hydrogenated oils from your diet; incorporate healthy foods like foods high in fiber, chromium, magnesium, healthy fats and clean protein, along with foods with low glycemic loads; take supplements for diabetes; follow my diabetic eating plan; and exercise to balance blood sugar.


Fibromyalgia

Fibromyalgia facts

What is fibromyalgia?

What causes fibromyalgia?

Is fibromyalgia hereditary?

What are risk factors for fibromyalgia?

What are fibromyalgia symptoms and signs? What are fibromyalgia tender points?

How do health care professionals test for and diagnose fibromyalgia?

What specialties of doctors treat fibromyalgia?

What is the treatment for fibromyalgia?

Are there any home remedies for fibromyalgia?

What is the prognosis of fibromyalgia?

Is it possible to prevent fibromyalgia?

Are there support groups for fibromyalgia?

What is the latest research on fibromyalgia?

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Fibromyalgia facts

What is fibromyalgia?

What causes fibromyalgia?

Is fibromyalgia hereditary?

What are risk factors for fibromyalgia?

What are fibromyalgia symptoms and signs? What are fibromyalgia tender points?

How do health care professionals test for and diagnose fibromyalgia?

What specialties of doctors treat fibromyalgia?

What is the treatment for fibromyalgia?

Are there any home remedies for fibromyalgia?

What is the prognosis of fibromyalgia?

Is it possible to prevent fibromyalgia?

Are there support groups for fibromyalgia?

What is the latest research on fibromyalgia?

Fibromyalgia facts

Fibromyalgia is a pain syndrome characterized by chronic pain, fatigue, and tenderness to touch.

Fibromyalgia syndrome is the most common medical cause of chronic, widespread pain in the United States.

Fibromyalgia affects 2%-4% of people, mostly women.

Defining fibromyalgia symptoms and signs include

chronic pain, which may be in the muscles, joints, and/or bones,

fatigue,

unrefreshing sleep, and

tenderness throughout the body to light touch.

Those with fibromyalgia may also experience

depression and/or anxiety,

cognitive difficulties, such as forgetfulness and lack of concentration (fibro fog),

abdominal pain,

dry eyes,

chest wall pain,

dry mouth,

bladder symptoms,

pelvic pain,

heart palpitations,

numbness and tingling,

chemical sensitivities and multiple allergies, and

weight gain.

Exercise and getting enough sleep are very important in the management of fibromyalgia. Taking medications can help relieve the pain.

The fact is there is no test to detect fibromyalgia. When a health care professional suspects fibromyalgia, sometimes tests are necessary to exclude other medical conditions.

What is fibromyalgia?

Fibromyalgia syndrome is a chronic pain condition (not a type of arthritis) that affects 4% of people in the United States. The disorder commonly affects the muscles and ligaments and usually has been present for years when a health care professional diagnoses the condition. Fibromyalgia was formerly known as fibrositis.

What causes fibromyalgia?

Fibromyalgia syndrome has been shown to be genetic. The disorder frequently becomes evident after stressful events. The stressful events may be emotional (such as a traumatic life event), physical (such as a motor-vehicle accident), or medical (such as certain infections). The chronic pain of rheumatoid arthritis, systemic lupus erythematosus, and other health conditions and autoimmune diseases can trigger the development of fibromyalgia.

The manner in which the brain and spinal cord process pain sensations is abnormal in fibromyalgia. The threshold at which stimuli cause pain or discomfort has been proven to be lower in fibromyalgia. The pain felt is more intense because the pain is amplified by the abnormalities in the central nervous system and in pain processing. Because of this, things that are not normally painful may be painful for someone with fibromyalgia. In addition, fibromyalgia causes the pain from any given cause to be worse. For example, a patient with fibromyalgia may find a massage painful instead of pleasant. In addition, back pain that someone without fibromyalgia experiences as moderate may be experienced as severe by someone with fibromyalgia, because the pain is amplified by abnormalities in pain processing by the central nervous system.

Quick GuideFibromyalgia Symptoms, Diagnosis & Treatment

Fibromyalgia Symptoms, Diagnosis & Treatment

Fibromyalgia is characterized by tender points.

Fibromyalgia Symptoms

The main symptom of fibromyalgia is pain that is believed to derive from an increased sensitivity to pain stimuli. The pain can be brought on by different situations, including noises, weather changes, or stress, but it may also occur without any relation to external events. The characteristic pain usually affects the neck, buttocks, shoulders, arms, upper back, and chest. "Tender points" are localized areas of the body that are tender to light touch. The tender points of fibromyalgia are commonly located around the elbows, shoulders, knees, hips, back of the head, and the sides of the breastbone.

Other common symptoms associated with fibromyalgia include

fatigue, malaise, or tiredness,

sleep disturbances,

migraine,

numbness or tingling in the hands and feet or various body parts, and

irritable bladder.

Read more about fibromyalgia symptoms »

Is fibromyalgia hereditary?

Increasing evidence supports a strong genetic component to fibromyalgia. Siblings, parents, and children of people with fibromyalgia are eight times more likely to have the disorder than those who have no relatives with the health condition. There are several genes that have been suspected to play a role in fibromyalgia syndrome. Studies in twins suggest that half the risk of fibromyalgia and related disorders is genetic and half is environmental.

What are risk factors for fibromyalgia?

Because it is in part hereditary, a family history of fibromyalgia syndrome is a risk factor for the development of fibromyalgia. Other risk factors include autoimmune diseases such as rheumatoid arthritis, lupus, and ankylosing spondylitis, as people with these diseases are more likely to have fibromyalgia than the general population. These patients are referred to as having "secondary fibromyalgia" because the autoimmune disease may trigger fibromyalgia.

Other emotional and physical stressors such as physical trauma (especially involving the spine and trunk), emotional stress, and certain infections (hepatitis C, Epstein-Barr virus, parvovirus, and Lyme disease but not the common cold) are associated with the development of fibromyalgia in some.

Fibromyalgia Symptoms, Diagnosis, and Treatment

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What are fibromyalgia symptoms and signs? What are fibromyalgia tender points?

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The defining feature of fibromyalgia syndrome is chronic widespread pain and tenderness. This means pain in multiple areas of the body, most commonly in muscles, tendons, and joints. Joint stiffness is common, as well. The pain is generally above and below the waist, on the left side of the body and on the right side of the body but can be localized, often in the neck and shoulders or low back, initially. The pain is chronic, which means it is present for more than three months. People commonly feel as if they "hurt all over" with flu-like symptoms, or are about to develop a cold or the flu. It is common for some days to be worse than others, and many patients report "flare-ups" where their pain and other symptoms are worse for several days in a row or longer.

Fatigue is the other universal symptom of fibromyalgia. It is most noticeable upon awakening, but it may also be marked in the mid-afternoon. It is very common to wake up in the morning not feeling refreshed, even after sleeping through the night. Patients commonly feel they sleep "lightly" and may have multiple nighttime awakenings with difficulty returning to sleep.

While widespread pain, fatigue, and sleep problems are the defining symptoms of the syndrome, fibromyalgia is associated with many other symptoms. Disordered thinking (cognitive disturbances) is often referred to as "fibro fog." Patients describe difficulty with attention and completing tasks, as well as a general sense of being in a fog.

Depression and anxiety co-occur in 30%-50% of patients at the time of diagnosis with fibromyalgia. Headaches are present in more than half of patients. Patients also may have a variety of poorly understood additional symptoms, including abdominal pain, diarrhea, constipation, nausea, dry eyes, dry mouth, chest wall pain, pelvic pain, and bladder symptoms, heart palpitations, numbness and tingling (pins and needles), multiple allergies and chemical sensitivities, weight gain, and others.

Fibromyalgia tender points

The physical examination is remarkable for tenderness, particularly in specific anatomic locations, such as the back of the neck where the neck muscles connect to the skull. There are 18 such locations, which are referred to as fibromyalgia tender points. In the past, studies required patients to have 11 out of a possible 18 fibromyalgia tender points in order to be included in a scientific study on fibromyalgia, but this definition of fibromyalgia has changed in the past few years.

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How do health care professionals test for and diagnose fibromyalgia?

Health care professionals diagnose fibromyalgia based on the patient's symptoms, primarily widespread pain. Chronic widespread pain in the muscles and joints, in combination with fatigue and poor sleep, lead to the consideration of fibromyalgia. A health care professional will perform a thorough history and physical exam to exclude other illnesses presenting with similar symptoms.

There is no widely accepted blood test or X-ray test for fibromyalgia at this time. Any testing is done to exclude other conditions. Tests for inflammation are generally normal in isolated fibromyalgia.

Usually multiple soft-tissue areas ("fibromyalgia tender points") are tender to palpation. However, not all patients are tender at the tender points. In general, females are more likely to be tender at the classic fibromyalgia tender points than males.

The American College of Rheumatology developed new guidelines and diagnostic criteria to help diagnose patients with fibromyalgia. The new guidelines no longer require a certain number of tender points to be present to be confident that a patient has fibromyalgia. The new guidelines use pain and other symptoms of fibromyalgia to aid diagnosis. Patient questionnaires to assist in the diagnosis of fibromyalgia can be found online.

What specialties of doctors treat fibromyalgia?

Rheumatologists, internists, family medicine doctors, pain-management doctors, physical-medicine and rehabilitation doctors, and primary care providers all treat fibromyalgia. Health care practitioners other than physicians are also frequently involved in the treatment of fibromyalgia, including clinical psychologists, physical therapists, nurse practitioners, and physician assistants.

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What is the treatment for fibromyalgia?

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There are both medication and non-medication treatments for fibromyalgia. Medication treatments frequently help manage the pain and sleeplessness from which fibromyalgia patients suffer. However, the non-medication treatments are really the basis of treatment for fibromyalgia. The non-medication treatments for fibromyalgia include education, exercise, and stress reduction. Sleep disorders may require both medication and non-medication treatments.

Education about fibromyalgia is very important. Often patients have suffered with symptoms for years, and simply knowing why they have pain can be a relief, as many patients become anxious not knowing what is causing their symptoms. Patients should also be educated about treatment approaches, good sleep hygiene, and the importance of treating conditions that may contribute to their symptoms. For example, when a patient with rheumatoid arthritis has fibromyalgia as well, poor control of their rheumatoid arthritis may lead to worsening of fibromyalgia pain and sleeplessness.

An exercise program is crucial in the treatment of fibromyalgia and should include stretching, strengthening, and aerobic exercise. Many patients with fibromyalgia find it difficult to institute a regular exercise program because they feel they are too tired to exercise and they may perceive that their pain and fatigue worsen when they begin to exercise. However, numerous scientific studies have shown that exercise for fibromyalgia, especially aerobic exercise, can improve pain, physical function, and a sense of well-being. Starting slow and sticking with the exercise program is very important. Low-impact aerobic activities such as swimming, water aerobics, walking, and biking are activities that patients with fibromyalgia find helpful. Many patients find it helpful to exercise in the morning. Some patients find yoga helpful for strengthening and stretching. This should also be accompanied by an aerobic exercise program.

Stress reduction is important for the self-management of fibromyalgia symptoms. Many patients feel that their symptoms are triggered by stress. Stress reduction can be challenging. There are many stressors in life; some can be changed and others cannot. Stress reduction involves a combination of changing stressors that can be changed and learning to lessen the body's stress reaction to the stressors that cannot be changed.

Cognitive behavioral therapy is a form of psychological therapy whereby a therapist and patient work together, to establish healthy patterns of behavior by replacing negative thoughts with more productive thoughts and actions. This has been proven to work in fibromyalgia. This form of therapy can be done one on one in an office setting, or even over the Internet.

The non-medication therapies are the cornerstone of treatment for fibromyalgia. With them, many people improve and may not require medications. Moreover, without focusing on sleep hygiene, stress reduction and exercise, it is difficult to improve, even with medication.

When used with non-medication therapies, medication treatments can help improve sleep, pain, and function in fibromyalgia. Administration of medications is most effective for pain relief when combined with ongoing non-medication treatments as discussed above. Medications often used in the treatment of fibromyalgia include medications in the antidepressant class (medications originally developed to treat anxiety and depression) and anticonvulsants (medications originally developed to treat seizures).

Medications called "tricyclic antidepressants" have been used to treat fibromyalgia for many years. These medications include amitriptyline (Elavil), doxepin (Sinequan, Silenor), and desipramine (Norpramin). These medications are generally started in low doses and increased until adequate response is achieved. The advantage of these medications is that they are effective for sleep and pain, widely available, and less costly for most patients than some of the newer agents. Cyclobenzaprine (Flexeril) is a medication that is both a muscle relaxant and tricyclic antidepressant that can be used to help with sleep and pain in patients with fibromyalgia.

Medications in the antidepressant class that affect the serotonin and the norepinephrine neurotransmitters (SNRI antidepressants) are frequently used in the treatment of fibromyalgia. These medications include duloxetine (Cymbalta), milnacipran (Savella), and venlafaxine (Effexor). Norepinephrine is a neurotransmitter in the brain, and increasing the levels of norepinephrine with these medications decreases pain levels. Fluoxetine (Prozac) is an antidepressant that affects mainly serotonin at low doses but increases norepinephrine as well at higher doses. Higher doses of fluoxetine can be used to treat fibromyalgia pain.

Pregabalin (Lyrica) and gabapentin (Neurontin) are anticonvulsants (medications initially developed to treat seizures). There are many scientific studies showing that pregabalin and gabapentin can be effective for fibromyalgia pain.

Tramadol (Ultram) is an opioid pain reliever which is helpful in some patients with fibromyalgia but should be used with caution as sometimes the use of opioids can worsen the pain cycle in fibromyalgia.

Memantine (Namenda) is a medication commonly used for dementia. Preliminary studies show that memantine may be helpful with pain and other symptoms of fibromyalgia, but further studies are needed to confirm this.

There have been small scientific studies of low-dose naltrexone (Revia, Vivitrol) in fibromyalgia. Naltrexone's main scientifically proven use is in treating narcotic addiction. In one small study, a very low dose of naltrexone was shown to benefit some patients with fibromyalgia. Further studies of low-dose naltrexone in fibromyalgia are needed to know if it really works.

A few notes on other treatments for fibromyalgia: Acupuncture can be helpful for some patients with fibromyalgia but is not usually recommended as one of the first-line treatments for fibromyalgia because the scientific studies on acupuncture for fibromyalgia patients have not shown definite benefit. Likewise, trigger point injections can be helpful for some patients. Alternative medicines have not been proven to be helpful in fibromyalgia; in particular, scientific studies on guaifenesin (Mucinex) show that it does not work. Of note, patients with vitamin D deficiency can have widespread arthralgia and myalgia, like fibromyalgia, which improves with vitamin D supplementation. While having a sufficient level of vitamin D is important to maintain bone health, a healthy immune system, and perhaps prevent certain types of cancer, vitamin D supplementation does not improve fibromyalgia symptoms in patients who have sufficient levels of vitamin D. Narcotic pain medications should be avoided in fibromyalgia because they may worsen the underlying problem.

Are there any home remedies for fibromyalgia?

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The non-medication treatments for fibromyalgia are the cornerstone of treatment of the syndrome. These are education, stress reduction, improving sleep, and exercise.

Quick GuideFibromyalgia Symptoms, Diagnosis & Treatment

Fibromyalgia Symptoms, Diagnosis & Treatment

What is the prognosis of fibromyalgia?

The overall mortality is not increased in patients with fibromyalgia, and it is not an organ-threatening disease. However, many patients with fibromyalgia continue to suffer from long-term widespread pain. Once the diagnosis is confirmed, many fibromyalgia patients find their overall sense of well-being and their pain improves to more moderate levels with the treatments discussed above. There are some patients who experience a dramatic reduction in pain with changes in their life to reduce stress. However, these patients are always at risk for worsening of their symptoms in the future and should maintain efforts for a healthy lifestyle, including sleep hygiene, ongoing exercise, and stress management. Fibromyalgia patients have a higher rate of disability than the general population, but seeking permanent disability status is generally discouraged because it frequently leads to worsening of symptoms.

Fibromyalgia Symptoms, Diagnosis, and Treatment

Fibromyalgia Overview Slideshow

Take the Fibromyalgia Quiz

Fibromyalgia Treatments and Tips to Ease Pain and Other Symptoms

Fibromyalgia: 12 Tips for Coping Slideshow

Is it possible to prevent fibromyalgia?

Fibromyalgia is a syndrome with a genetic predisposition. It can be triggered by certain events, but the exact events leading to the onset of fibromyalgia is unknown. Because of this, there is no known way to prevent fibromyalgia. However, leading a healthy lifestyle, including getting enough sleep, eating healthy foods, and exercising, is the best way to stay healthy.

Are there support groups for fibromyalgia?

Yes, there are support groups for fibromyalgia. Local support groups and further information can be found through the Arthritis Foundation (http://www.arthritis.org), National Fibromyalgia Association (http://www.fmaware.org), or the National Fibromyalgia Partnership, Inc. (http://www.fmpartnership.org).

What is the latest research on fibromyalgia?

There is ongoing medical research on fibromyalgia on many fronts. There is active research on the genes responsible for fibromyalgia, new medications, and new non-medication therapies to help pain. One recent study found that non-restorative sleep -- when one wakes up feeling tired after a full night of sleep -- is strongly tied to developing widespread pain. Medical researchers have linked anxiety to developing widespread pain.

Quick GuideFibromyalgia Symptoms, Diagnosis & Treatment

Fibromyalgia Symptoms, Diagnosis & Treatment

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Medically Reviewed on 5/8/2018

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By Lynn Marks

Medically Reviewed by Samuel Mackenzie, MD, PhD

Fibromyalgia is a chronic (long-term) disorder defined by pain and tenderness throughout your body, as well as fatigue.

People with fibromyalgia tend to have a heightened sense of pain. This feeling is sometimes described as a constant muscle ache.

Formerly known as fibrositis, fibromyalgia is often considered a rheumatic, or “arthritis-like,” disorder. But unlike arthritis and certain related conditions, it doesn't cause damage to joints, muscles, or other tissues.

Fibromyalgia isn't a progressive disease, which means that it won't steadily worsen over time.

There's no cure for fibromyalgia, but treatments are available that may help relieve symptoms and improve your quality of life.

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How Common Is Fibromyalgia?

Fibromyalgia is one of the most common chronic pain disorders.

It affects about 10 million adults in the United States, as well as 3 to 6 percent of the world’s population, according to the National Fibromyalgia Association (NFA).

Although fibromyalgia can occur in anyone, it's more common in women. Between 75 and 90 percent of people diagnosed with the disorder are women, the NFA estimates.

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But at least some of this gender disparity may be due to bias in how doctors approach the diagnostic process, according to Don L. Goldenberg, MD, a rheumatologist and professor emeritus of medicine and nursing at Oregon Health and Science University in Portland.

The disorder affects people of all races and ethnicities. It’s slightly more common if you smoke, are obese, have a lower level of education, or experienced trauma during your childhood, according to Dr. Goldenberg.

Most people with fibromyalgia are diagnosed between ages 20 and 50, with symptoms typically showing up months or even years beforehand. Even children can have fibromyalgia.

But the incidence of the condition rises with age, so that by age 80, 8 percent of people meet the criteria for fibromyalgia, says the NFA.

What Causes Fibromyalgia?

Researchers don't know exactly what causes fibromyalgia, but it seems to occur when the body's central nervous system doesn't process pain properly.

While pain in fibromyalgia may feel like it’s coming from a specific area of your body, “It’s actually coming from the brain, from the central nervous system,” says Goldenberg. “The pain is not where you think it is.”

Even though it’s often grouped with rheumatic diseases like arthritis and lupus, fibromyalgia isn’t considered to be a disease of inflammation, or a joint or muscle disorder.

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Conditions That Cause Joint Pain

Conditions That Cause Joint Pain

It’s also not an autoimmune disorder — a condition in which the body’s immune system mistakenly attacks healthy tissues.

Goldenberg says that it’s a mistake to view fibromyalgia in simple cause-and-effect terms.

“The central nervous system is hypersensitive or hyperirritable,” he says. “It’s like the thermostat is set too high on sensitivity to your nervous system.”

But symptoms of fibromyalgia often begin after physical or emotional trauma, such as an illness, surgery, infection, stressful life event, or injury.

Some experts believe these events may trigger the onset of the disorder, but it’s unclear exactly how this connection could be explained.

According to the Mayo Clinic, repeated stimulation may cause the brains of people with fibromyalgia to change — leading to an increase in chemicals, known as neurotransmitters, that signal pain.

The actual pain receptors in the brain may also undergo changes, developing a kind of “memory” that leads them to overreact to pain signals.

To complicate matters, fibromyalgia can also occur seemingly spontaneously, in the absence of trauma.

Genetics may also play a role. Fibromyalgia is often seen in families, and having a relative with the disorder puts you at increased risk for it.

But genes alone aren’t responsible for fibromyalgia, according to the American College of Rheumatology.

Who Treats Fibromyalgia?

There’s no one medical specialty that treats fibromyalgia. Some family practice doctors or internists (internal medicine specialists) can recognize and manage the condition.

Other types of doctors who commonly treat fibromyalgia include:

Rheumatologists, internists who specialize in treating arthritis and diseases of the joints, muscles, and soft tissues

Neurologist, who treat diseases of the brain and nervous system

Pain management doctors, who treat all forms of pain, including that caused by fibromyalgia

Pain Specialists

Dr. Lucinda Bateman: Fighting the Fight Against Pain and Fatigue

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Before making an appointment with any of these specialists, ask whether they treat fibromyalgia. Not all rheumatologists, neurologists, or pain management specialists are knowledgeable about fibromyalgia.

Symptoms and Diagnosis

Fibromyalgia is known for causing widespread pain and tenderness throughout the body, as well as fatigue. It can also cause difficulty sleeping, problems with memory or concentration (“fibro fog”), dizziness, numbness and tingling in the hands and feet, sensitivity to bright lights or loud noises, headaches, digestive issues, and dry eyes or mouth.

Because the symptoms of fibromyalgia overlap with those of many other conditions, diagnosing fibromyalgia can be difficult. In fact, it’s not uncommon to see several doctors and have many medical tests to rule out other conditions before getting a diagnosis of fibromyalgia.

Learn More About Fibromyalgia Symptoms and Diagnosis

Myths and Facts About Fibromyalgia

There’s a lot that medical professionals still don’t know about fibromyalgia, and the same holds true of the general public and the millions of people living with the condition. It is perhaps no surprise, then, that certain myths and outdated beliefs about fibromyalgia persist in some quarters.

At the same time, much has been learned about fibromyalgia over the years, so many of the common misconceptions and misunderstandings about the condition can now be firmly put to bed.

For individuals who have fibromyalgia, being informed is the best way to get good treatment and understand what lifestyle measures will help with symptoms.

Learn More About Fibromyalgia Myths and Facts

Common Overlapping Conditions

Having certain other medical conditions may be another risk factor for fibromyalgia.

In many cases, it isn’t clear whether these conditions might trigger the onset of fibromyalgia, or whether they are instead an effect of fibromyalgia — or whether both conditions are due to some other underlying cause.

People with fibromyalgia often also have:

ADHD

Allergies

Neck or back pain, including disk disease

Chronic fatigue syndrome

Endocrine disorders, such as thyroid problems

Esophageal motility disorders (problems with swallowing)

Painful menstrual periods

Breathing issues, such as hyperventilation

Sjögren’s syndrome, an autoimmune disorder that causes dry eyes and mouth

Lyme disease

Heart valve problems

Enthesopathies (detachment of a tendon or ligament)

Irritable bowel syndrome (IBS)

Tension headaches or migraines

Temporomandibular joint (TMJ) syndrome, a condition that causes jaw pain

A mood disorder, such as anxiety or depression

Restless legs syndrome, a limb movement disorder characterized by unpleasant sensations in the legs

Endometriosis, a condition in which tissue grows outside a woman's uterus

A rheumatic disease, such as osteoarthritis, rheumatoid arthritis, lupus, or ankylosing spondylitis

Vestibular disorders, such as vestibular neuritis or Ménière’s disease

Sleep disorders, such as obstructive sleep apnea or chronic insomnia

Treatment for Fibromyalgia

Fibromyalgia is often best treated with a combination of approaches. For some people, certain types of prescription medication can help to reduce symptoms. For others, drugs have little effect, and for everyone, drugs have side effects that must be balanced with potential benefits.

According to the American College of Rheumatology, physical exercise is the most effective treatment for fibromyalgia. Gentle stretching and aerobic exercise can relieve pain and also prevent deconditioning, or getting weaker from lack of exercise. Exercise can also improve sleep. Working with a physical or occupational therapist can be helpful in getting started with an exercise regimen.

Some other lifestyle approaches that may improve fibromyalgia symptoms include stress reduction, not smoking, following a healthy diet, losing weight if you’re overweight, and establishing good sleep habits.

Learn More About Fibromyalgia Treatment

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Drugs Approved for Fibromyalgia

Cymbalta (duloxetine)

Lyrica (pregabalin)

Savella (milnacipran)

Exercise for More Energy and Symptom Relief

Engaging in exercise may be the last thing on your mind when you hurt all over, but in fact, not exercising can make your pain worse. The best approach to being physically active when you have fibromyalgia is to start low and go slow. In other words, start with a few minutes of activity, and gradually increase the amount of time you’re active over several weeks or months to build your strength and endurance.

It’s better to do a little less than you’re capable of than to push too hard and trigger a fibromyalgia flare.

If you’re having a flare, reduce the time and intensity of your exercise sessions, but don’t be completely inactive.

Learn More About Good Exercises for People With Fibromyalgia

Fibromyalgia and Diet

For some people, making dietary changes can ease their fibromyalgia symptoms. Simply following a balanced, nutritious diet is a good start toward better health overall. Such a diet is high in whole foods, contains good sources of vitamin D such as cold-water fish or fortified milk or orange juice, includes foods high in magnesium such as dried beans and leafy greens, and is rich in antioxidants from deeply colored fruits and vegetables.

Beyond that, some research suggests that avoiding dietary excitotoxins — chemicals that excite the neurons in the brain — can provide additional symptom improvement. The most common excitotoxins in the Western diet are food additives used to enhance or sweeten the flavor of foods. Monosodium glutamate is an example of such an additive.

Learn More About What to Eat and What to Avoid

The Link Between Rheumatoid Arthritis and Fibromyalgia

Rheumatoid arthritis (RA) and fibromyalgia are two distinct disorders, but, according to the Arthritis Foundation, up to 30 percent of people with RA also develop fibromyalgia. When the two conditions occur together, pain from one can trigger or exacerbate pain from the other.

Among the key differences between RA and fibromyalgia are that RA is an autoimmune disease while fibromyalgia is not, and RA causes inflammation in and around the joints while fibromyalgia does not attack the joints. The pain of fibromyalgia tends to be widespread, seemingly coming from many points of the body at once.

Each condition is treated differently, but staying physical active can be helpful in both.

Learn More About the Link Between Rheumatoid Arthritis and Fibromyalgia

Is It Psoriatic Arthritis or Fibromyalgia?

Just as people with RA have a higher-than-average risk of developing fibromyalgia, so do people with psoriatic arthritis, a systemic autoimmune disease and an inflammatory form of arthritis. While there are different types of psoriatic arthritis, ultimately, they all cause joint pain, stiffness, and loss of function.

Doctors suspect co-occurring fibromyalgia when a person with psoriatic arthritis experiences persistent pain and fatigue, possibly accompanied by other symptoms of fibromyalgia, such as fibro fog, sleep problems, and irritable or overactive bladder.

One hazard of not recognizing fibromyalgia in a person with psoriatic arthritis is that a doctor might increase a drug dosage or change drug treatments for the psoriatic arthritis unnecessarily, possibly compromising that person’s treatment. Another hazard is that the fibromyalgia goes untreated.

Learn More About How Doctors Distinguish Between Psoriatic Arthritis and Fibromyalgia

Fibromyalgia Complications

The constant pain, fatigue, and lack of sleep associated with fibromyalgia can interfere with your daily life.

Many people are unable to function at work or at home, and become frustrated because this condition is often misunderstood.

Specific complications of fibromyalgia may include:

Mental Fog Some people with fibromyalgia experience lasting memory and cognitive problems that interfere with their ability to concentrate. This is often known as "fibro fog."

Hospitalization People with fibromyalgia are about twice as likely as others to be hospitalized for any reason, according to the Centers for Disease Control and Prevention (CDC).

Depression The CDC notes that people with fibromyalgia are more than three times as likely as others to have major depression, which makes mental health screening extremely important.

Death From Suicide or Injury The risk of death from these causes is higher than in the general population, though the overall risk of death isn’t any higher in people with fibromyalgia, according to the CDC.

Resources for Information and Connection

Living with fibromyalgia can be a frustrating and often lonely existence, particularly if you don’t know anyone else who has it. But with the growth of social media, it’s possible to at least connect online with others who have fibromyalgia, and many towns and cities have in-person support groups as well.

Getting good information about the disorder is important, too, and a number of organizations, including the National Fibromyalgia Association and the American College of Rheumatology, offer authoritative facts and guidance on managing fibromyalgia.

Learn More About Fibromyalgia Resources

Additional reporting by Quinn Phillips.

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Last Updated: 4/5/2018

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Everything you need to know about fibromyalgia

Last updated Fri 5 January 2018

By Christian Nordqvist

Reviewed by Nancy Carteron, MD, FACR

Symptoms Treatment Causes Diagnosis Diet Tender points

Fibromyalgia is a common and chronic syndrome that causes bodily pain and mental distress.

Symptoms of fibromyalgia can be confused with those of arthritis, or joint inflammation. However, unlike arthritis, it has not been found to cause joint or muscle inflammation and damage. It is seen as a rheumatic condition, in other words, one that causes soft tissue pain or myofascial pain.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), around 5 million adults aged 18 years or over in the United States experience fibromyalgia, and 80 to 90 percent of fibromyalgia patients are women.

Fast facts on fibromyalgia:

Here are some key points about fibromyalgia. More detail is in the main article.

Fibromyalgia causes widespread pain, fatigue, and other types of discomfort.

Symptoms resemble those of arthritis, but fibromyalgia affects the soft tissue, not the joints.

The cause is unknown, but risk factors include traumatic injury, rheumatoid arthritis and other autoimmune disorders, such as lupus, and genetic factors.

There is no cure, but medications, exercise, acupuncture, and behavioral therapy can help relieve symptoms and improve sleep quality.

Symptoms

Fibromyalgia can lead to widespread pain, sleep problems, and other symptoms.

Fibromyalgia can lead to widespread pain, sleep problems, and other symptoms.

Common symptoms include:

widespread pain

jaw pain and stiffness

pain and tiredness in the face muscles and adjacent fibrous tissues

stiff joints and muscles in the morning

headaches

irregular sleep patterns

irritable bowel syndrome (IBS)

painful menstrual periods

tingling and numbness in the hands and feet

restless leg syndrome (RLS)

sensitivity to cold or heat

difficulties with memory and concentration, known as "fibro-fog"

fatigue

The following are also possible:

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problems with vision

nausea

pelvic and urinary problems

weight gain

dizziness

cold or flu-like symptoms

skin problems

chest symptoms

depression and anxiety

breathing problems

Symptoms can appear at any time during a person's life, but they are most commonly reported around the age of 45 years.

Treatment

Medical attention is needed because fibromyalgia can be difficult to manage. As it is a syndrome, each patient will experience a different set of symptoms, and an individual treatment plan will be necessary.

Treatment may include some or all of the following:

Around 20 percent of people with fibromyalgia try acupuncture within the first 2 years. It may work, but more research is needed.

Around 20 percent of people with fibromyalgia try acupuncture within the first 2 years. It may work, but more research is needed.

an active exercise program

acupuncture

psychotherapy

behavior modification therapy

chiropractic care

massage

physical therapy

low-dose anti-depressants, although these are not a first-line treatment

People with fibromyalgia need to work with their doctor to come up with a treatment plan that provides the best results.

Drugs

Drugs may be recommended to treat certain symptoms.

These may include over-the-counter (OTC) pain relievers. However, the European League Against Rheumatism (EULAR) issued a recommendation against using non-steroidal anti-inflammatory drugs (NSAIDs) to treat fibromyalgia in their updated 2016 guidelines.

Antidepressants, such as duloxetine, or Cymbalta, and milnacipran, or Savella, may help reduce pain. Anti-seizure drugs, such as gabapentin also known as Neurontin, and pregabalin, or Lyrica, may be prescribed.

However, a review has suggested that patients often stop using these drugs because they are not effective in relieving pain or because of their adverse effects.

Patients should tell the doctor about any other medications they are taking to avoid side-effects and interactions with other drugs.

Exercise

A combination of aerobic exercise and resistance training, or strength training, has been linked to a reduction in pain, tenderness, stiffness, and sleep disturbance, in some patients.

If exercise is helping with symptoms, it is important to maintain consistency in order to see progress. Working out with a partner or personal trainer may help to keep the exercise program active.

Acupuncture

Some patients have experienced improvements in their quality of life after starting acupuncture therapy for fibromyalgia. The number of sessions required will depend on the symptoms and their severity.

One study found that 1 in 5 people with fibromyalgia use acupuncture within 2 years of diagnosis. The researchers concluded that it may improve pain and stiffness. However, they call for more studies.

Behavior modification therapy

Behavior modification therapy is a form of cognitive behavioral therapy (CBT) that aims to reduce negative, stress- or pain-increasing behaviors and improve positive, mindful behaviors. It includes learning new coping skills and relaxation exercises.

Relieving chronic pain with behavioral strategies

Relieving chronic pain with behavioral strategies

Learn more about how behavioral therapy can help relieve chronic pain

Read now

Causes

The exact cause of fibromyalgia is unclear. However, current thinking in the field of Rheumatology suggests that fibromyalgia is a problem with central pain processing in the brain, where there may be an increased sensitivity or perception of pain to a given trigger.

There is a range of likely risk factors, including:

a stressful, traumatic physical or emotional event, such as a car accident

repetitive injuries

rheumatoid arthritis or other autoimmune diseases, such as lupus

central nervous system (CNS) problems

the way our genes regulate how we process painful stimuli

Fibromyalgia may also be hereditary. Females who have a close relative with fibromyalgia have a higher risk of experiencing it themselves.

People with rheumatoid arthritis, lupus, or spinal arthritis, known ankylosing spondylitis, have a higher risk of developing fibromyalgia, as do patients with some other rheumatic diseases.

Diagnosis

It can take some time to confirm a diagnosis of fibromyalgia because the symptoms resemble those of other conditions, such as hypothyroidism. These conditions must first be ruled out before diagnosing fibromyalgia.

There are no laboratory tests for the condition, and this, too, can lead to delayed or missed diagnosis.

The American College of Rheumatology has established three criteria for diagnosing fibromyalgia.

pain and symptoms over the previous week, out of 19 identified body parts, plus levels of fatigue, unsatisfactory sleep, or cognitive problems

symptoms that have been ongoing for at least 3 months

no presence of another health problem that would explain the symptoms

Previously, 'tender points' were used to diagnose the condition. However, these are no longer recommended to aid the diagnosis of fibromyalgia.

Diet

Dietary measures have been suggested for improving the symptoms of fibromyalgia.

These include:

High-energy foods that are low in sugar: Foods such as almonds, beans, oatmeal, avocado, and tofu contain plenty of fiber but no added sugar. These can help boost energy throughout the day, helping to improve tiredness symptoms that occur as a result of the condition.

Avoiding foods that have gluten: A 2014 study has suggested that gluten sensitivity can contribute to fibromyalgia. The study showed that removing foods that contain gluten from the diet may be able to reduce the pain, even in patients who do not have celiac disease. This is also linked to a diet plan for reducing inflammation.

Cutting out fermentable oligo-di-mono-saccharides and polyols (FODMAP): A recent study showed that a diet low in FODMAP could have promising effects on pain levels in people with fibromyalgia.

Not eating additives and excitotoxins: One report showed that cutting out additives from the diet, such as aspartame and monosodium glutamate (MSG), can reduce pain symptoms significantly. The pain of the people involved in the study was also shown to increase once these additives were put back in the diet.

Eating more seeds and nuts: There is little evidence to support a direct relationship between seeds, nuts, and an improvement in fibromyalgia symptoms. However, they are known to contain powerful micronutrients and minerals that are important for cell function, and this may support people with the condition.

Maintaining a balanced diet and healthy weight is vital to ongoing health and can improve a person's quality of life. Studies have shown that people with both fibromyalgia and obesity showed an improvement in quality of life and pain symptoms once they lost weight.

More research is needed on the effects of diet on fibromyalgia, but making sure the diet is low in sugar and gluten is a good starting point. There is certainly no harm is trying these options to support treatment.

Tender points

When reading up on fibromyalgia, you may have come across the term 'tender points.'

These are certain areas of the body in which fibromyalgia is said to cause the most pain. These include the back of the head, inner knees, and outer elbows. Pain can also be increased in the neck and shoulders, the outer hips, and the upper chest.

Doctors used to diagnose fibromyalgia based on how they react to pressure at these points. However, this is no longer seen as an accurate way to diagnose the condition, and tender points are no longer used as a reliable indicator of fibromyalgia.

Injections are not advised at these points. However, the pain is now thought to be more widespread and present differently in different people. Instead of specific areas or points of pain, fibromyalgia is identified by the severity and chronic nature of the pain.

Seek medical attention to rule out other causes of pain in these areas.

Outlook

There is no definitive cure for fibromyalgia, but more treatment options and clearer diagnostic criteria are now available.

Symptoms can improve significantly, as long as the patient follows their treatment plan.

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Fibromyalgia

mother and daughter at grocery store

Fast Facts

Fibromyalgia affects two - four percent of people, women more often than men.

Fibromyalgia is not an autoimmune or inflammation based illness, but research suggests the nervous system is involved.

Doctors diagnose fibromyalgia based on all the patient’s relevant symptoms (what you feel), no longer just on the number of tender places during an examination.

There is no test to detect this disease, but you may need lab tests or X-rays to rule out other health problems.

Though there is no cure, medications can reduce symptoms in some patients.

Patients also may feel better with proper self-care, such as exercise and getting enough sleep.

Fibromyalgia is a common neurologic health problem that causes widespread pain and tenderness (sensitivity to touch). The pain and tenderness tend to come and go, and move about the body. Most often, people with this chronic (long-term) illness are fatigued (very tired) and have sleep problems. The diagnosis can be made with a careful examination.

Fibromyalgia is most common in women, though it can occur in men. It most often starts in middle adulthood, but can occur in the teen years and in old age. You are at higher risk for fibromyalgia if you have a rheumatic disease (health problem that affects the joints, muscles and bones). These include osteoarthritis, lupus, rheumatoid arthritis, or ankylosing spondylitis.

What is fibromyalgia?

What causes fibromyalgia?

How is fibromyalgia diagnosed?

How is fibromyalgia treated?

Living with fibromyalgia

The role of the rheumatologist

Additional Information

Updated March 2017 by Suleman Bhana, MD and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.

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