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Gallstones: Calculi.Solid pebble-like masses found in the gallbladder and in the bile duct leading from the liver.Gallstone come in various sizes and composition.They are formed from bile,a digestive liquid produced by the liver and stored in the gallbladder.Most gallstones do not cause symptoms.Gallstones occur in about 1 to 10 people over the age of 40 with twice as many women as men being affected.Gallstones may run in famiies and are more common in Native America & Hispanic people for unknown reasons.Bile, the liquid from which gallstones are formed,is made up mainly of the fatty substance cholesterol,pigments and various salts.A change in the composition of bile may trigger stone formation.Most gallstones are a mixture of cholesterol and pigments.In about 1 in 5 cases stones consist of cholesterol only and in about 1 in 20 cases stones consist of pigment only.Often,there are many stones and some can reach the size of golf ball

Causes: There is often no obvious cause for gallstones.However cholesterol stones are more likely in people who are very overweight or who eat a high-fat diet.Pigment stones may form if there is excessive destruction of red blood cells,as may occur in haemolytic anaemia and sickle-cell anaemia.Poor emptying of the gallbladder caused by narrowed bile ducts may also increase the risk of gallstones

Symptoms: Often no symptoms.However symptoms may occur if one or more stones block the cystic duct - the exit from the gallbladder - or the common bile duct - the main bile duct from the liver to the duodenum.A stone that partiially or completely blocks the flow of bile will cause attacks known as biliary colic,which cause symptoms that include - very severe upper abdominal pain,nausea & vomiting,episodes are normally brief and typically occur following a fatty meal,which cause the gallbladder to contract.Stones that remain lodged in the bile ducts block the release of bile, causing severe inflammation or infection of the gallbladder and bile ducts.Blocked bile ducts may also cause jaundice (also see under jaundice), a condition in which the skin and whites of the eyes become yellow.In additon to jaundice,blockage of the common bile duct may cause inflammation of the pancreas.Most people become aware that they have gallstonses by chance when an unrelated condition is being investigated

Treatment: If your doctor suspects from your symptoms that you have gallstones,you may have blood tests to check your red blood cell count and cholesterol levels.You may also have imaging tests such as ultrasound scanning.If a bile duct is found to be blocked,the exact position of the gallstones may be located using a specialized imaging procedure - ERCP in which an endoscope is used to inject a contrast medium into the bile ducts prior to X-rays being taken

Gallstones that do not cause symptoms need no treatment.If you have mild or frequent symptoms adopting a diet that is low in fat may prevent further discomfort.If your symptoms are persistent or become worse, you may have your gallbladder removed by conventional surgery or by endoscopic surgery.Removal of the gallbladder usually cures the problem. The absence of a gallbladder does not usually cause any health problems and the bile simply drains continuously through a duct directly into the intestines.In very rare cases, the stones re-form in the bile-duct and may need to be removed by open surgery or during endoscopic examination.Drugs are available that dissolve gallstones made of pure cholesterol,but it may take months or years for the stones to dissolve completely.Alternatively you may be treated with ulatrasonic shock waves (lithotripsy),which shatter the stones into tiny pieces so that they pass painlessly into the small intestines and are excreted in the faeces.Use of drugs or ultrasonic shock waves avoids the need for surgery.However,because the gallbladder is still present there is an ongoing risk that further gallstones will form

*also see Cholecystitis*

Gammaglobulin: A type of blood protein that includes Antibodies.Obtained from donated blood, gammaglob ulin can be used in the prevention of infections such as hepatitis

Ganglion: A harmless swelling in the sheath of tissues that contains tendons. Usually found near a joint, most commonly on the back of the wrist - also on the palm, finger, heel or ankle

Gangrene: Death and decay of the fingers,toes, limbs or other parts of the body that occurs when their blood supply is cut off

Gastrectomy: Surgical removal of part or all of the stomach

Gastritis: A Inflammation or irritation of the stomach lining. Acute or chronic

Gastrocnemius: Calf Muscles.The Gastrocnemius and the Soleus Muscles at the back of the calf are concernd with walking, running and standing

Gastroenteritis: Type of Food poisoning by eating contaminated food, usually by bacteria.Inflammation of the lining of the stomach and intestines. This is a SERIOUS condition in children and babies,because symptoms can rapidly lead to DEHYDRATION

Gastraoesophageal Reflux (GOR): (Heartburn / Acid Reflex) Gastroesophageal reflux,acidic juices are regurgitated into the oesophagus from the stomach.This regurgitation causes a pain or discomfort in the upper abdomen and chest,known as heartburn,one cause is a Hiatus Hernia. Gastroesophageal reflux (GOR) commonly known as heartburn or acid reflux is probably the most common cause of indigestion.The discomfort is due to acidic juices from the stomach flowing back up into the oesophagus (the gullet,the tube leading from the throat to the stomach).The lining of the oesophagus does not have adequate defence against the harmful effects of stomach acid,which causes inflammation,sometimes even ulceration and a burning pain kwown as heartburn

Causes: The stomach contents are prevented from entering the oesophagus by a double-action valve mechanism - the lower end of the oesophagus has a muscular ring,known as the ower oesophageal sphincter, which forms one part of the valve mechanism,and the other part consists of the Hiatus,a narrow opeing in the diaphragm muscle.The combination of these two muscular gateways provides an effective one-way valve.GOR may develop as a result of several factors acting together to make the valve leak 1. poor muscle tone in the sphincter 2. increased abdominal pressure due to pregnancy & obesity 3. a weakness in the Hiatus that allows part of the stomach to slide into the chest - Hiatus herna 4. many people develop mild attacks of GOR after eatiang rapidly or eating certain foods,especially pickles,fried or fatty meals,, or drinks,especially carbonated soft drinks,alcohol or coffee.Smoking worsens symptoms too

Symptoms: The main symptoms of GOR are usually most noticeable immediately after eating a large meal or when bending over.They include 1. a burning pain or discomfort in the centre of the chest behind the breastbone,known as heartburn 2. an acidic taste in the mouth due to regurgitation of acidic fluid into the throat or mouth 3. erosion of theteeth due to acid 4. persistent cough and sometimes asthma at night and sore throat 4. hoarseness of the voice 5. belching 5. streaks of blood in the vomit or faeces

6. Longterm Problems: GOR that persist over many years can cause scaring in the oesophagus,which may eventually be severe enough to cause stricture (narrowing).A stricture can make swallowing very difficult and may lead to weight loss.Chronic GOR, may lead to the oesophageal lining replacing the stomach lining,increasing the risk of developing oesophageal cancer

Treatment: The good news is that many products and treatment are now available to alleviate chronic heartburn and prevent stomach acid from damaging cells of the oesophagus- which have no protection against a frequent bath of acid.Acid reflux may also be aggrevated by drugs you can take for other conditions,so consult your doctor about the effects of both over-the-counter and prescription medications you take and ask whether substitutions may be helpful.More severe cases that do not respond to diet and lifestyle changes alone require medications,starting with over-the-counter antacids and Zantac (ranitidine) help,but may not be strong enough to control acid reflux fully.If not, your doctor can prescribe more potent acid suppressors called proton-pump inhibitors - such as Loser.Other potentially useful drugs protect the lining of the oesophagus and speed stomach acid emptying.If acid reflux cannot be controlled through diet, habits and drugs - surgery may be required.One of the newest procedures done through a laparoscope,involves wrapping a defective oesophageal sphincter to strengthen it against reflux.Experts agree that it is not enough merely to claim all the symptoms of heartburn.Rather acid reflux must be prevented and any cellular damage that has occurred must be healed.It is not enough to treat chonic heartburn sporadically stopping treatment when symptoms subside.It has to be long-term.To protect the oesophagus adequately,treatment must be aggressive,continuous and indefinite and so involves some major changes in your life.If you have heartburn two or more times in a week,see your doctor and perhaps request a consultation with a gastroenterologist.If the problem has been long-standing,an examination and biopsy of the oesophagus through an endoscope is the only good way to assess what damage has been done.If any.If there are abnormal cell changes,endoscopic examinations should be done every year or two to check for possible progression towards cancer.Should a pre-cancer condition develop,the oesophagus can be removed and replaced with a piece of intestine or stomach.There are also experimental treatments that use laser or other forms heat to obliterate the abnormal cells and allow healthy cells to replace them

Self-help for chronic heartburn: Check food well and eat slowly.Watch what you eat.Stay away from spicy or fatty food as well as citrus juice,coffee,tea,alcohol or chocolate.Eat 5 or 6 meals rather than two large meals a day.Immediately after a meal,avoid exercising,bending over or lying down.Lose weight if you need to.You will feel better if there is some food in your stomach,so eat little and often.Raise your head of your bed by about four inches or sleep on at least 4 pillows.Antiacid tablets will help to neutralize the acids and protect the oesophagus.Give up smoking.Consult your doctor if the problem occurs 2 or 3 more times a week. If you have recently developed pain the the centre of your chest that seems to be unrelated to mealtimes,you should seek immediate help - because the heart condition Angina may sometimes be mistaken for the pain of severe heartburn

Genital Herpes: Herpes Simplex is the name of a virus that can cause cold sores or genital sores,depending on whichever bit of skin is infected.Herpes is called a cold sore on the face,but you can get it on the genitals or anywhere else.Cold sores are often due to a mother passing on the virus on to her children through kissing.In genital Herpes the virus is transmitted through infected skin coming into contact with a partner's skin e.g during sex or from mouth to genitals during oral sex.It is more common in women because their genital areas are warmer and more moist than that of men

Causes: Genital Herpes was originally thought to be caused only by the Herpes Simplex Type 2 while cold sores on the lips were thought more likely to be due to Herpes Simplex Type 1. However with the increase in oral sex - this distiction has become blurred.Blood tests show most of us have been exposed to the Herpes Simplex virus by the time we reach middle age.Millions of people are infected with the virus but probably only one-quarter of those infected have symptoms of any kind.Many people have what is called a sub-clinical attack - with no visible signs of infection and no ill effects.These people don't know they have been infected

Once in the body,the virus can retreat to nerve cells near the base of the spine.If the virus is reactivated,it can return to where it entered the body and cause a recurrence.Not all people have recurrence,some have a few and for some the problem recurs from time to time.Usually the initial attack is the most severe

Symptoms: Genital Herpes is highly contagious.New research indicates that the virus can also be transmitted by people who do not have any symptoms.Symptoms appear between three and seven days after sexual contact with an infected partner.The genital skin feels oversensitive to the touch.Itching and irritation around the genitals.A general feeling of being unwell.Headache.Muscle aches and joint pains.Abdominal pain.Shooting pain in the lower limbs.Enlarged tender glands in the groin.Pain on passing urine.Blisters appear within a few hours,enlarge,burst and become painful ulcers within two to three days.The ulcers from scabs and take 14-21 days to heal completely

Triggers for Re-currence: Recurrence do not depend on having intercourse with an infected partner.Attacks can be triggered by: physical and mental stress.Excessive cold or heat,including fever.Irritation of delicate genital tissue.Local genital trauma - rough sexual intercourse,plucking or shaving of pubic hair.General ill health and other infections such as a cold causing fever

Treatment Genital Herpes: should always be looked at by a doctor and not treated by yourself at home.See your doctor immediately if you feel numb or sensitive in the genital area or if you have had sexual relations with anyone with the Herpes Virus.There is no cure for Genital Herpes but the sooner treatment is given the more likely it will prevent or ameliorate an attack.Antiviral drugs,such as Acyclovir,taken as tablet make the ulcers less painful and encourage healing if taken early in the attack.Other remedies include bathing the area with salt solution (a heaped spoon of salt in a pint of water).Over-the-counter Acyclovir cream should not be used to treat genital herpes,though it works better on facial cold sore.Painful blisters canbe relieved by a soak in a tepid bath with salt added and cold packs (not ice) applied to the infected area.To prevent genital herpes recurring get plenty of rest and eat a balanced diet with nutritional foodstuffs and plenty of liquids.Manage stress by learning relaxation excercises or taking up yoga.Wear loose underwear so air can circulate and keep your genitals cool.Leave the sores exposed to air as much as possible.Keep a record of when you get recurrent attacks in an attempt to find a pattern.If,for example recurrence and related to rough sex,try using a lubricant such as KY jelly.You should try taking 200IU (international units) of vit E daily which may improve your body's immune response

Precaution: Herpes is for life.Never have sex if you have symptoms,except with the person from whom you got it - or whom you gave it to.When both partners have the same virus,they don't reinfect each other.Never have unprotected sex with a stranger.Never have oral-genital sex if you have a cold sore or if your partner has one.Never be dishonest about your herpes.It is best to be open about Herpes Simplex and tell your partner.And you must avoid skin contact when the virus is active.It may be easier to explain that you sometimes get cold sores on your genitals.Never be shy to tell your doctor about possible contacts

Pregnancy: You should inform your doctor - if pregnant and if you or your partner has had an attack of Genital Herpes or have had Herpes

Cancer: The herpes virus may have a role in the development of cervical cancer,so women who have had genital herpes should have a cervical smear test regularly

Genital Warts: Genital warts,like warts on hands or feet are caused by a virus,in this case the Human Papilloma Virus (HPV).These warts grow in and around the entrance of the vagina and the anus and on the penis.They can be transmitted sexually or they can just grow in the genital area much as they grow.Genital warts can be as tiny as pin heads or take on a distinctly cauliflower-like appearance.A man may not actually know that he has a wart - because it may be hidden inside the urethral opening and a woman can have a wart deep inside the vagina which she doesn't know about.There may be an interval of up to 18 months between infection and the appearance of the warts

You should not automatically assume you have caught them from a recent sexual contact.Warts are spread through skin-to-skin contact.If you have sex or genital contact with someone who has genital warts you may develop them too.Not everyone who comes into contact with virus will develop warts.As with all infections, the immune system plays an important role,so if this is depressed in any wasy (eg. pregnancy) due to HIV, or to generally being run down,the warts will be difficult to treat

Symptoms: Genital warts may occur singly or in groups,and individual may have dozens of warts or just one or two.They may itch,but usually painless.Often there are no other symptoms and the warts may be difficult to see.In women,warts can develop inside the vagina and on the cervix,warts on the cervix may cause slight bleeding or very rarely,an unusual-coloured vaginal discharge.In men,warts on the scrotum or shaft of the penis usually resemble the ordinary warts that occur on the hands.Under the foreskin and round the anal area,they are usually a shiny pinkish white.A doctor or nurse can usually tell whether you have genital warts just by looking.If warts are suspected but not obvious,the doctor may apply a weak vinegar-like solution to the outside of the genital area.This turns any warts white

Cervical Cancer: In women,an association between the human papilloma virus (HPV) and the development of casncer of the cervix has been established.Cervical cancer is more common in women who suffer from HPV than in the rest of the population.It is extremely important for any woman who has either suffered from genital warts herself or has had unprotected sex with a man with genital warts to have regular smear tests

Safety Precausion: Go to your doctor or nearest clinic for a diagnosis and treatment.Avoid sexual intercourse or use condoms for 12 weeks after the warts have gone.Condoms will only protect against the wart virus if they cover all the affected areas,As with Herpes,genital warts can be transmitted through non-penetrative sex if areas on the outsided of the genitals are affected

Important Facts about Wart Infections: Infection with the Human Papilloma Virus is very common.Condoms offer some protection but it is best to seek advice from the doctor / clinic.As warts are sexually transmitted it is always worth practising safe sex.Having a check-up to exclude other sexually transmitted infections.It is your partner(s) right to know that you have HPV - in order to protect themselves or what to look out for in case he/she develops genital warts.All woman should ensure that they are part of the routine cervical screening programme

Treatment of Genital Warts: You should never try to treat genital warts yourself.Rather don't try to treat warts in the genital area with any of the wart lotions you can buy from the chemist.These are for use on the hands only.Warts can disappear of their own accord.However the problem has not necessarily disappeared.As the virus can remain in the skin,warts may re-occur

There are a number of different treatments and the choice depends on a number of factors,including the appearance and site of the warts.Not all treatments work all the time and your doctor may need to select an alternative after the first.Many of these treatments kill the cells that are affected with the virus,leaving small sores that heal over

1. Podophyllotoxin Sollution and Podophyllotoxin Cream (WARTICON) - This treatment can be applied in the clinic or at home by the patient.A typical coure of treatment lasts up to 4 weeks

2. Podophyllin Solution - This treatment has to be administered by clinical staff.It must be washed off by the individual within 4 hours - because it is toxic and can irritate the surrounding skin if left in contact for too long

3.TCA (Trichloraocetic Acid) - This is a caustic chemical applied to the warts by the clinical staff

4.Immune Response Modifiers (IMIQUIMOD) - These enhance the immune system's ability to fight the virus responsible for genital warts

5. Cryotherapy - This involves freeezing the warts with liquid nitrogen by clinical staff.This kells the cells in the wart and some of the surrounding skin

6. Cauterizing (Hyfrecation) - This involves burning of the warts by clinical staff wiht an electrically heated probe,after numbing the area with local anaesthetic

7. Lazer Treatment - This may be done under general or local anaestheitic at the clinic - useful for treating large warty areas.The heat of the lasers kill the cells

8. Surgery - Surgical removal of warts may be doen under general anaesthetic in hospital

Giardiasis: Giardia Lamblia-Parasite infection of the Digestive system

Gingivitis: Inflammation of the gums

Glandular Fever: Infectious Mononucleosis.It is a Viral infection,causing swollen lymph nodes and a sore throat that is common in adolescence & early adulthood.Glandular ferver is known as the 'kissing disease' of adolescence and early adulthood - because it is mainly transmitted in saliva.Its name come from the symptoms,which include widespread swollen lymph glands and a high temperature.Initially teh illness may be mistaken for tonsillitis,but it is more severe and lasts longer

Causes: Infectious mononucleosis is caused by the Eptein-Barr virus (EBV),which attacks lymphocytes - the white blood cells that are responsible for fighting infection.EBV infection is very common and about 9 in10 people have been infected by the age of 50.More than half of infected people do not develop symptoms and consequently are unaware that they have been infected

Symptoms: If symptoms of infectious mononucleosis develop,they usually do so 4-6 weeks after infection and appear over several days.Symptoms may include 1. high fever and sweating 2. extremely sore throat,causing difficulty swallowing 3. swollen tonsils,often covered with a thick greyish-white coating 4. enlarged,tender lymph glands in the neck and armpits and groin 5. tender abdomen as the result of an enlaged spleen 6. rash 7. These distinct symptoms are often accompanied by poor appetite 8. weight loss 9. headache 10 . fatigue 11. In some people,the sore throat and fever clear up quickly and the other symptoms last less than a month 12. Other people may be ill longer and may feel letharic and depressed for months after the infection 13. Glandular fever was one of the first virus infections recognized as leaving behind post-viral fatigue syndrome

Treatment: Your doctor will probably diagnose the infection from your enlarged lymph nodes,sore throat and fever.A blood test may be carried out to look for antibodies against EBV (Epstein-Barr virus) in order to confirm the diagnosis. A throat swab may also be taken to exclude bacterial infection,which would need to be treated with antibiotics.There is no specific treatment for infectious mononucleosis,but simple measures may help relieve symptoms.Drinking plenty of cool fluids,and taking over-the-counter painkillers,such as paracetamol,may help control the high fever and pain.Contact sports should be avoided while the spleen is enlarged because of the risk of rapture,which causes severe internal bleeding and can be life-threatening

Prognosis: Almost everyone who has infectious mononucleosis,makes a full recovery eventually.However, in some people recovery may be slow adn fatigue and depression may last for weeks or even months after the symptoms first appear.One attack of the disease,with or without symptoms,provides life-long protection

Glaucoma: Disease of the Eye in elderly people

Glue Ear: Chronic-Secretory Otitis Media.Mainly in children.The Eustachian tube and middle ear fill with fluid as a result of infection.Painless, but should be treated SERIOUSLY, can lead to deafness and eventually permanent loss of hearing

Gluteus maximus: Buttock Muscles that helps with standing & climbing

Gonorrhoea: Venereal Disease transmitted by Gonococcus Bacterium during sexual activity.It is a bacterial infection that causes genital inflammation and discharge.Once diagnosed it can usually be eradicated by antibiotics but, as strains are becoming resistant to conventional therapy,it is important to seek specialist help

Gout: Excess of Uric-Acid collection in various organs.Disorder in which the chemical processes of the body are upset

Greenstick Fracture: Most common type of fracture in children whose bones are still growing and bendy.The bone bends rather than breaks and in this type of fracture,minimal damage occurs in the surrounding tissue. If a long bone in the arm or leg bends,it may crack on one side only,producing an incomplete break called a 'greenstick' fracture *alsos see under fractures*

Group Therapy: There are many forms of group therapy - but all rely on one basic premise - they set out to help individuals to take well-defined steps towards being able to deal with their problems alone.There are usually four steps 1. to discover what the real problems are 2. to rationalize them 3. to adjust to them 4. to cope with them.Whatever the form of group therapy,this step-by-step progress is facilitated by the presence of others.It may be possible to identify with another group members and share experiences.It may be possible to assess behaviour in others as irrational even though it is difficult to recognize and admit to the same thing in oneself when alone.In group therapy members use the group as a crutch,a cathartic and an instrument to work through their own difficulties.With successful group therapy,however,the patient ceases to be dependant on the group and has the confidence to face life alone

Growth Hormone Deficiency: Condition when the Pituitary Gland in the Brain, which produce the Growth Hormone, fails to produce enough and leads to stunted growth.The treatment for growth hormone deficiency is sophisticated and replacement therapy is easily controlled, giving good results.If a very few cases, condition is caused by a Tumour in the Pituitary gland

Guillain-Barre Syndrome: Rare condition of Inflammation of Nerves

Gynaecomastia: Is the common,normal enlargement of one or both breasts in males and has no sinister signifiance. I's most often seen in newborn babies and older men.All men produce small amounts of the female sex hormone estogen.If estrogen levels are higher than normal,breast enlargement - gynaecomastia, occurs.Either one or both breasts become enlarged.Gynaecomastia is common in newborn boys because of their mother's estrogen crossing the placenta.It affects a fair number of male adolescents too,because their own estrogen levels are swinging about.In babies and adolescent boys it is almost always temporary.Gynaecomastia can also affect older men when they have stopped producing the male hormone Testosterone but their adrenal glands and fat are still producing estrogen.The condition may also be a side effect of certain drugs e.g digoxin

info source:

South African Family Medical Adviser

Family Health Guide & The Baby & Child Health Care Handbook - Dr.Miriam Stoppard