American Medical Association Family Medical Guide - American Medical Association [636]
• Eat a healthy diet. Eat a balanced diet that is high in antioxidants (found in abundance in fruits and vegetables) and low in fat and cholesterol to improve your cholesterol profile (see page 146) and help prevent high blood pressure (see page 574) and atherosclerosis (hardening of the arteries).
• Exercise regularly. Exercise for 20 to 30 minutes at least three to four times per week to reduce stress, lower blood pressure, prevent atherosclerosis, and promote restful sleep. Moderate aerobic exercise, such as brisk walking, is very helpful.
• Stop smoking. Stop using all tobacco products. The nicotine in cigarettes, cigars, and chewing tobacco impairs circulation by narrowing blood vessels and raising the level of LDL (bad) cholesterol, which are factors in high blood pressure and atherosclerosis. Smoking also lowers skin temperature, which can trigger symptoms.
• Avoid wearing tight-fitting jewelry, shoes, or socks. Wearing tight-fitting watches, bracelets, rings, socks, or shoes can compress the vessels that supply blood to the fingers and toes.
See your doctor as often as recommended so he or she can monitor your condition, evaluate how well your treatment is working, and detect and treat other health problems early. If the self-help measures do not prevent episodes or relieve your symptoms, your doctor will probably prescribe calcium channel blockers (see page 563) to keep the blood vessels open. In most cases, this type of medication reduces the frequency and severity of episodes and promotes healing of sores on the fingers and toes. If calcium channel blockers are not effective, the doctor may prescribe alpha blockers (see page 563) to block the effects of norepinephrine, a hormone in the body that causes blood vessels to narrow. In some cases, doctors prescribe angiotensin-receptor blockers (see page 563) to widen the arteries and improve blood flow. To heal skin sores, the doctor will probably recommend nitroglycerin ointment, which you apply directly to your fingers or toes to increase the blood supply to the area and promote healing.
In rare cases, when the disorder is severe and continues to worsen, doctors recommend a surgical procedure called a sympathectomy, in which the sympathetic nerves (the nerves that stimulate constriction of the blood vessels) are cut to interrupt the nerve pathways and prevent the capillaries from constricting. However, relief of symptoms from the surgery may last for only a couple of years.
Sjögren’s Syndrome
Sjögren’s syndrome is an autoimmune disorder in which the body’s immune system mistakenly attacks and damages the moisture-producing glands that manufacture tears and saliva. The disorder can affect glands in other parts of the body as well, causing dryness in the nose, throat, airways, skin, stomach, pancreas, intestines, or vagina. When the disorder extends beyond the moisture-producing glands it can affect the whole body, including the joints, lungs, kidneys, blood vessels, and nervous system.
There are two types of Sjögren’s syndrome—primary and secondary. The primary form appears by itself, and the secondary form occurs along with another autoimmune disease, such as rheumatoid arthritis (see page 918) or systemic lupus erythematosus (see page 920). People with the secondary type are likely to have more health problems than people with primary Sjögren’s syndrome.
People who develop Sjögren’s syndrome probably have a genetic susceptibility to the disorder, but having a gene for the condition does not necessarily mean that you will develop the syndrome. Some sort of trigger must activate the immune system’s faulty response; doctors think that this trigger may be a viral or bacterial infection. Once the infection stimulates the immune system to act, the suspected gene alters the immune system’s response, sending fighter cells to the moisture-producing glands, where they cause inflammation that damages the glands. The fighter cells then continue their attack long after the infection has cleared up.
Sjögren’s syndrome is one of the most prevalent