Doctor Kaminstein is a Board Certified Gastroenterologist, who is presently not in active medical practice due to disability. Before disability, Dr. Kaminstein practiced Gastroenterology/Hepatology in West Chester, PA for over 15 years.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Synthetic cortisone medications (corticosteroids) simulate
cortisol,
a naturally occurring, anti-inflammatory hormone produced by
the adrenal
glands. Such drugs (for example, prednisone) have since benefited
many, but are
not without potential side effects.
The two major problems related to continuous steroid
treatment are:
drug side effects and
symptoms due to changes in the
balance of
normal hormone secretion (withdrawal symptoms).
The production of corticosteroids is controlled by a
"feedback
mechanism," involving the adrenal glands, the pituitary
gland and
brain-the "Hypothalamic-Pituitary-Adrenal Axis"
(HPAA).
Using large doses for a few days, or smaller doses for more
than two
weeks, leads to a prolonged decrease in HPAA function.
Steroid use cannot be stopped abruptly; tapering the drug
gives the
adrenal glands time to return to their normal patterns of
secretion.
Withdrawal symptoms (weakness, fatigue, decreased appetite,
weight
loss, nausea, vomiting, diarrhea,
abdominal pain) can mimic
many other
medical problems. Some may be life-threatening.
Tapering may not completely prevent withdrawal symptoms;
steroid
withdrawal may involve many factors, including a true
physiological
dependence on corticosteroids.
Patients should carry a list of all your medications in your
wallet to
alert medical personnel in case of emergency.
Supplementation with corticosteroid medication may be
needed during
periods of stress (such as surgery), even up to a year after
stopping
corticosteroid therapy.
Reference: Encyclopedia Britannica Online; "Medicine in the 20th century - Endocrinology - Cortisone"
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
The inflammatory bowel diseases (IBD) are Crohn's disease (CD) and ulcerative colitis (UC). The intestinal complications of Crohn's disease and ulcerative colitis differ because of the characteristically dissimilar behaviors of the intestinal inflammation in these two diseases.
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
There are many unusual symptoms of asthma, including sighing, difficulty sleeping, anxiety, chronic cough, recurrent walking pneumonia, and rapid breathing. These symptoms may vary from individual to individual. These asthma complexities make it difficult to accurately diagnose and treat asthma.
Anabolic steroids are synthetic substances that are related to testosterone and promote skeletal muscle growth and the development of male sexual characteristics in both men and women. In the 1930s, it was discovered that anabolic steroids could promote skeletal muscle growth in lab animals, which lead to anabolic steroid abuse by bodybuilders and weight lifters.
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