Ask Dr. Etingin: Ablation for varicose veins … Constipation … Antihistamines
Q: My doctor has recommended a procedure called ablation to remove a painful varicose vein in my calf. Can you explain what’s involved?
A: Ablation is minimally invasive surgery carried out using a catheter inserted through a small incision into the affected vein. In radiofrequency ablation, an electrode is inserted into the catheter and heated; the heat causes the vein to collapse and seal as the catheter is removed. Laser ablation is similar, but instead of an electrode, a laser fiber is introduced through the catheter. Both procedures are performed under ultrasound guidance and typically take about one hour.
You’ll be given a local anesthetic, and, while you may feel some pressure as the catheter is inserted, you shouldn’t feel any pain as the veins are destroyed. You’ll need to wear a compression stocking after the procedure to help reduce any swelling and decrease the risk of blood clots. You should be able to resume normal activities within a few days.
Q: I don’t have a bowel movement every day. Do I have constipation?
A: It isn’t essential to have a bowel movement every day—a normal range varies from three times a day to three times a week, depending on the person. Constipation is defined as having a bowel movement less than three times a week and passing stools that are hard, dry, small, and difficult to eliminate.
Constipation may occur for several reasons, including a diet that is low in fiber, dehydration, and lack of physical activity. Other causes include medications (including those used to treat high blood pressure, depression, pain, and Parkinson’s disease) and health problems such as stroke, diabetes, and an underactive thyroid. A new onset of constipation could be a symptom of disease; if you experience a sudden change in your bowel habits, alert your doctor.
Increasing the amount of fiber you consume can help prevent and ease constipation. High-fiber foods include whole grains, beans, and many fruits and vegetables. If you increase your fiber intake, be sure to drink plenty of water, as this softens stools and helps them move through your colon. If these measures don’t work, your doctor may suggest a short-term laxative.
Q: What are antihistamines, and how do they work?
A: Antihistamines are medications that reduce or block histamine, a chemical produced by the body during an allergic reaction. Antihistamines also may be used as sedatives and sleep aids, and they are found in some cold and cough remedies.
Allergy symptoms, including sneezing and itchy, watery eyes, occur when your body is trying to rid itself of an allergen—a substance that produces an allergic reaction.
Most antihistamine drugs are available over the counter; they come in various forms, including tablets, liquids, nasal sprays or gels, and eye drops.
There are two types of antihistamines: “first-generation,” which may cause drowsiness, and “second generation,” which usually do not cause drowsiness. Examples of medications that contain first-generation antihistamines include Benadryl, Dimetapp, and Chlor-Trimeton. Sleep aids that contain antihistamines include Nytol, Unisom, NyQuil, and Sominex. Second-generation antihistamines include loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra).
Antihistamines can interact with other medications, and they can make some health conditions worse. If you have heart disease, high blood pressure, kidney or liver disease, hyperthyroidism, or glaucoma, ask your doctor or pharmacist if it’s safe for you to take antihistamines.
-Orli R. Etingin, M.D.
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