However, in most cases, treatment aims to deal with minor problems such as labor issues and the functioning in society, as well as any additional symptoms of anxiety or depression. Psychotherapy may help the patient deal with chronic physical discomfort and understand how to handle it.

People with somatization disorder may have difficulty accepting a referral to a mental health professional or to accept that evaluation and medical treatment may not relieve symptoms. These patients are particularly sensitive to the stigma associated with mental disorders. Also, sometimes these mental disorders are ruled out by a subgroup of physicians who see these symptoms as a legitimate cause for concern.

If possible, it is best if the physician and mental health professionals work together because this way assesses the patient’s physical symptoms while he helps manage the frustration of not reaching a diagnosis or plan clear treatment. It may be possible that patients receive help treating any anxiety disorder and depression present, helping to manage conflict in your home and finding ways to help it function well.

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Somatization disorder is a chronic (long) usually begins before age 25 or 30 years, but may begin in adolescence and can persist for several years.

Prevention

Although there is no way to prevent somatization disorder, proper diagnosis of it can help the person avoid excessive medical tests. This means a challenge for the person with the disorder and the doctor, because new symptoms could be caused by a medical problem that is not somatization disorder.

When To Call a Professional

The faster a mental health professional evaluate the patient, faster result will help deal with the consequences of this disorder, such as exposure to unnecessary evaluation and treatment, difficulty with relationships and poor productivity at work. However, a person with this disorder may avoid treatment when you visit a mental health professional.

Forecast

The drugs may provide some relief. Psychotherapy works long term because the person probably has lived with the disorder for a long time before receiving treatment. It is hard to abandon the model long-time behavior, however, with persistence and support, you may make progress.

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The old saying, “the more you learn, the more you earn” certainly does apply to the physical fitness industry. Employers want to know that you have what it takes to work for them, and one of the best ways to prove this is by including education in your list of qualifications. Past work experience is helpful, but may not be required if you have the education and skills that show you are a worthy job candidate.

Personal trainer courses can be completed by anyone at any age. It is often said that it is never too late to begin a new career. It is also never too late to earn more money in your current career. Many employers are willing to pay all, or a portion of the costs of continuing education so long as the classes are within your current field. Be sure to ask your employer if this type of plan is in place, as it will benefit you both.

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Symptoms usually manifest over several years. the person may feel distressed and function poorly at work and home. The medical evaluation does not explain the symptoms or the symptoms exceed what would be expected in a particular medical condition. Symptoms include:

* Pain such as headache, back pain, stomach pain, joint pain and chest pain.
* Gastrointestinal symptoms: nausea, vomiting or diarrhea.
* Sexual symptoms: erectile dysfunction.
* Menstrual problems: irregular periods.
* Neurological symptoms: problems with coordination or balance, paralysis, numbness, weakness, vision problems or seizures.

Diagnosis

There are no laboratory tests to determine whether a person has somatization disorder. The doctor may suspect this condition when the person complains several times over the years and shows few signs of possible medical condition to define.

The doctor may perform tests to detect diseases that could be seen as somatization disorder, such as multiple sclerosis and systemic lupus erythematosus (lupus), or fibromyalgia syndrome, chronic fatigue syndrome and irritable bowel syndrome.

If the doctor thinks that a person has somatization disorder, the patient should check for signs of depression and anxiety and referral to a mental health professional for further examination.

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The person does not “pretend.” Somatization disorder is a medical problem. However, this disorder is probably related to brain function and emotional regulation and not the body area that has become the center of patient care. The symptoms are real and the person has no conscious control of the same.

People with somatization disorder reported medical problems over the years, affecting many areas of the body. For example, the same person could have back pain, headaches, chest discomfort, upset stomach and urinary tract discomfort. Women often report irregular menstrual periods, while men may experience erectile dysfunction (impotence). The person may:

* Describe symptoms in dramatic and emotional terms
* Seek help more than one doctor at the same time
Describe symptoms in vague terms
* Lack of specific signs that describe a disease
* Complain that medical tests fail to help

Many people with psychiatric illness do not describe their symptoms in dramatic terms. Therefore, if the person behaves in a dramatic way, this does not necessarily mean that the person suffers from somatization disorder.

People with somatization disorder also have another diagnosable medical condition, so doctors must be careful not to dismiss the symptoms quickly.

A person with somatization disorder may also have symptoms of anxiety and depression. The person may begin to feel useless and attempt suicide, or may have trouble adjusting to the stresses of life. The person may use alcohol or drugs, including prescription drugs.

Spouses and family members may be anxious because the patient’s symptoms continue for long periods of time and no medical treatment seems to help.

The symptoms of somatization disorder vary across cultures. Cultural factors also affect the proportions of men and women with this disorder.

Women, relatives of people with somatization disorder are more likely to develop the disorder.

The men, relatives of patients with this disorder are more likely to become alcoholics and personality disorders present.

Although scientists have some theories, know what causes some of the symptoms reported by people with somatization disorder. It is possible, for example, that people with this disorder perceive in an unusual body sensations. The trauma and stress may alter the physical sensations of the person.

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Treatment

No smoking is very important to prevent lung damage.

Specific therapy is available, consisting of intravenous infusion of the protein deficit. Damage does not recover the set, but can avoid the progressive deterioration of lung function. Its benefits on liver disease are less clear. No currently available gene therapy.

New treatments are being tested, ranging from the use of sprays to deposit the deficient protein in the lungs, to try gene therapy to introduce the gene deficit. Unfortunately, to date, are more a hope than a clinical reality

The treatment of lung or liver disease is similar to that used in diseases due to other causes. This will relieve the symptoms, increases survival and improves quality of life, but does not stop the progression of the disease.

Therefore, if the disease progresses and causes serious damage to the lungs or liver, consider lung transplantation or liver.

The deficiency of alpha-1 AT is an inherited disease most often requires liver transplantation. However, very few children with deficiency of alpha-1 AT require transplantation. When necessary, the results are usually good, with 90% survival the first year and 80% at 5 years. Sometimes, you need liver transplantation in adults, with results not so good, in part by the presence of associated lung damage.

Living with the disease

The prognosis for patients with deficiency of alpha-1 AT is usually good. Many patients are asymptomatic and are unaware they have this problem.

Unfortunately, a minority of patients develop liver disease and / or progressive lung, which can be very serious, with serious damage to these organs and need for transplantation. These patients need frequent monitoring of liver function (blood tests, ultrasound, etc..) And lung function (spirometry, chest radiographs, CT, etc.)..

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It is unlikely that the doctor involved in the diagnosis, given the rarity of the disease.

Liver disease in children are rare, so that the patient is likely to be referred to the pediatrician. Hospitalization is often needed to make a thorough study. Sometimes it may be necessary to enter or query in a specialized center for childhood liver diseases in general only exists in large cities (university hospitals).

Once diagnosed the disease, the physician may collaborate actively in the management of the disease, but under the supervision of specialist.

Good advice

It is very important to stop smoking. Or not start smoking, if a “screening” of the family is found deficiency of alpha-1 AT. Smoking greatly increases the risk of lung damage occurs in patients with deficiency of alpha-1 AT.

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As with all rare diseases, one of the most important factors is that the physician considers the diagnosis. Thus, liver disease are rare in children, so that this possibility is considered fast. But in adults is easier than going unnoticed because there are other common causes of liver disease. It is thought that many cases go unnoticed, and only a minority are diagnosed.

Faced with a rapidly progressive pulmonary emphysema or occurs at an early age should always be suspected.

Once considered a possible diagnosis, confirmation is easy with a blood test measuring levels of alpha-1 AT. Sometimes it is a chance finding, as seen in the serum protein (analysis of blood proteins) absence of the band of alpha-1-globulins.

Phenotyping is a blood test that determines the types or variants of the protein alpha-1 AT in your blood circulating through the technique of electrophoresis. This test is important to detect carriers of defective genes, because sometimes they can have normal levels of alpha-1 AT in your blood. Variants of the alpha-1 AT phenotypes are identified as (Pi * or protease inhibitor) with letters of the alphabet.

The next step is to identify the genotype, or exact variants of alpha-1 AT. This can be done from a liver biopsy or blood analysis.

Tests for the family and genetic counseling

The testing to the families of those affected, including analysis of the levels of alpha-1 AT in order to offer genetic counseling. Prenatal diagnosis is possible, but no guidance about the future severity of the disease.

Differential Diagnosis

In children

Liver disease in newborns may be due to infections during pregnancy or shortly after birth, resulting in hepatitis. Other causes can be found in drug toxicity or hereditary diseases, including deficiency of alpha-1 AT. Other hereditary diseases that cause liver damage include alterations in the metabolism of sugars or amino acids and cystic fibrosis.

In cases of jaundice, you should always rule out obstruction of the bile duct, because their treatment is usually surgery. In the older child should be excluded diseases that produce liver thromboembolism of the arteries or the portal vein.

In adults

Emphysema, COPD and in general in adults is often associated with smoking or occupational exposure to toxic substances or dusty. Only 1-2% of cases of emphysema are due to deficiency of alpha-1 AT. Cirrhosis and liver failure in adults is usually due to alcoholism, chronic hepatitis (viral) or autoimmune liver disease and, more rarely, hemochromatosis or Wilson’s disease.

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The deficiency of alpha-1 AT predisposes to progressive damage of lung tissue by the protease activity especially when added contributing factors such as smoking. Cigarette smoke is a potent stimulator of protease activity, accelerating the damage that occurs in the lungs.

The deficiency of alpha-1 AT causes emphysema, a chronic lung disease characterized by destruction of alveolar walls and permanent abnormal enlargement of respiratory bronchioles and alveolar sacs. In this disease, emphysema, these areas are often located at the bases of the lungs but is usually diffuse emphysema.

Affected people, especially smokers, complain of exertional dyspnea, progressive.

Liver disease

In patients with genotype Pizza, which are at risk for liver disease Garve, the molecules of alpha-1 AT are defective and accumulate in liver cells, producing toxic effects.

Liver disease in childhood

The deficiency of alpha-1 AT is the most common inherited liver disease in childhood. The first symptoms are jaundice, pale stools, tendency to bleeding and liver enlargement, all typical signs of liver disease. This clinical syndrome is known as neonatal hepatitis, and usually appears between 4 days and 6 weeks.

A few of these babies develop a fulminant, with liver failure and cirrhosis. Most of these babies, hopefully, evolve favorably spontaneously disappear with jaundice and normalization of liver function tests, so they do not require urgent treatment.

By late childhood (10-15 years), some of these patients with deficiency of alpha-1 AT may develop signs of chronic liver disease and liver failure. Some of these children may have had jaundice or other liver problems soon after birth. The clinical manifestations are similar to those of other liver diseases: abdominal pain, jaundice, pruritus (itching of the body), swelling of the ankles (edema) or abdomen (ascites), enlarged liver and spleen, and so on. In severe cases, can cause gastrointestinal bleeding, stupor and coma.

Liver disease in adults

Symptoms of liver disease in adults with alpha-1 deficiency are similar to AT occur in older children, although the disease can take years to manifest. The symptoms are the same as in liver cirrhosis due to other diseases, jaundice, abdominal swelling, gastrointestinal bleeding, and eventually hepatic coma. The deficiency of alpha-1 AT is associated with an increased risk of hepatocellular carcinoma (liver cancer). This cancer can be the first manifestation of the disease.

Clinical manifestations in carriers of the disease

It is not clear that carriers of the disease, ie, those with a defective gene and one normal gene are predisposed to liver disease. It is possible that some liver diseases of unknown origin are associated with this situation. It is even possible that low levels of alpha-1 AT increase susceptibility or worsen the course of liver disease due to other causes, such as viral infections (hepatitis) or alcohol.

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The course of the disease depends largely on the genotype that determines the deficit and, therefore, the amount and quality of alpha-1 AT produced. But even people with the same genotype exhibit highly variable expression of the enfermedad.Como already mentioned, the deficiency of alpha-1 AT primarily affects the lungs and liver.

- In the lungs, the disease strongly predisposes to developing emphysema, a chronic and progressive disease of the lungs. This type of emphysema is usually detected at 30-40 years in smokers and in patients 50-65 years old non-smokers. This emphysema often worsen over the years, leading to respiratory failure and premature death in the next 15-20 years.

- The evolution of liver damage is more difficult to predict.

- Sometimes, it causes jaundice and other liver problems in newborns.

- Some newborns and infants develop rapidly progressive liver disease, but usually improve spontaneously.

- A minority of children with this problem, significant liver disease develops before age 20.

- Even in adulthood, liver problems may occur in these patients, although rare.

- Only a minority of these patients with deficiency of alpha-1 AT, even those with severe deficits (pizza), eventually develop liver cirrhosis.

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