The hypothalamus, also called the infundibulo-tuberian region, is an organ of the central nervous system located above the pituitary gland and in contact with the cerebellum. 

The hypothalamus is part of the brain. The brain includes the cerebral hemispheres, the diencephalon, the brain stem and the cerebellum. The diencephalon is covered by the cerebral hemispheres and includes three gray matter regions: the thalamus, the hypothalamus and the pineal gland. The hypothalamus is a small structure of 4 to 5 g and 4 cm3 in volume, located at the base of the brain. It can be arbitrarily divided into a medial and a lateral part. The medial part has three regions, anterior, middle and posterior. It is connected to the pituitary gland below by the pituitary stalk. The hypothalamus is made up of several nuclei containing nerve cells: supraoptic nuclei, paraventricular nucleus, infundibular nucleus, accessory nuclei... These nuclei are the places where hypothalamic hormones are produced. These hormones are produced by the hypothalamus but stored and then released by the posthypophysis. These two hormones are the antidiuretic hormone ADH and oxytocin.

The hypothalamus is under the control of the higher brain centers. In connection with the pituitary gland, it secretes neurohormones and is involved in endocrine and autonomic nervous system regulation. The term hypothalamus-pituitary axis is used to designate all the relationships established between the hypothalamus and the pituitary gland. The hypothalamus is the main integrating organ for the regulation of the internal environment, the sleep-wake rhythm, as well as the growth, body and mental development and reproduction of the species.

1. What is the purpose of the hypothalamus?

The hypothalamus is a very important integrating nerve center with an endocrine function. The hypothalamus is the center of all homeostatic controls. It is the regulator of physiological functions. It is directly involved in the regulation of the autonomic nervous system, itself involved in the functioning of the heart and vessels, respiration, mobility of the digestive tract, glandular secretions... in the regulation of thirst and water balance, through the stimulation of osmoreceptors, specific receptors sensitive to variations in the concentration of solutes, mainly sodium ions Na, in body fluids; in the regulation of appetite and satiety, through receptors sensitive to variations in blood concentrations of nutrients (glucose, amino acids...); in the regulation of temperature and body temperature, through the stimulation of osmoreceptors. ); in the regulation of body temperature, thanks to the existence of thermoreceptors sensitive to blood temperature and playing the role of thermostat; in the regulation of the sleep/wake cycle, but also in the regulation of biological impulses, in particular sexual impulses, hormonal secretions.

The hypothalamus is the endocrine brain of the body since it controls the secretion of all the endocrine glands of the body: TRH (thyreo releasing hormone) which stimulates the secretion and release of pituitary TSH (which stimulates the thyroid gland); GnRH ( gonadotrophin releasing hormone) which causes both FSH and LH release ( which regulate the secretion of the sex glands) ; CRF (cortico releasing factor) which promotes the release of ACTH from the pituitary gland and its synthesis (action on the adrenal gland which secretes cortisol). The other hypothalamic hormones are antidiuretic hormone, which regulates water balance, and oxytocin, which regulates uterine contractions during childbirth and the secretion of breast milk during lactation.) These 2 hormones are secreted in the hypothalamus and then transported by the pituitary stem to the posterior pituitary gland or post pituitary gland where they are stored.

2. What are the diseases of the hypothalamus?

The majority of hypothalamic dysfunction syndromes affect the hypothalamic-pituitary-adrenal axis. Because it is difficult for physicians to diagnose a specific gland that is not functioning properly, the disorders are often called hypothalamic-pituitary disorders.

Hypothalamic syndromes are a collection of endocrine, metabolic, neurological and other systemic signs and symptoms that can be caused by a wide range of disease processes. This malfunction of the hypothalamus which leads to the appearance of certain symptoms such as thirst and hunger disturbances, poor regulation of body temperature, diabetes insipidus (which is characterized by a difficulty for the organism and more precisely the kidneys to concentrate urine resulting in a significant urine leakage and intense thirst), adipsia (a tendency not to feel the need to drink for a long period of time), poor assimilation of sugars and fats leading to the appearance of obesity or, on the contrary, thinness, sleep and character disorders. The clinical syndrome depends on the location and extent of the underlying lesion. The lesion may be very small and affect only specific hypothalamic nuclei, resulting in discrete symptoms; on the other hand, larger lesions manifest with a variety of problems. There are many causes of hypothalamic dysfunction. The most common are surgery, brain injury, brain tumors (craniopharyngiomas, optic nerve gliomas), and radiation therapy to the brain. Other causes of hypothalamic syndrome are eating disorders (anorexia), extreme weight loss, blood vessel problems in the brain (aneurysm, pituitary apoplexy, subarachnoid hemorrhage...), genetic disorders, such as anorexia, anorexia, or anemia. ), genetic disorders such as Prader-Willi syndrome, familial diabetes insipidus, Kallmann syndrome, infections and inflammations (histiocytosis and sarcoidosis) due to certain immune system diseases, Frohlich syndrome.

Cocaine addiction has recently been associated with hypothalamic dysfunction. Diets high in saturated fatty acids cause mitochondrial dysfunction and an inflammatory response in the hypothalamus, which produces hypothalamic dysfunction, which promotes obesity.

The hypothalamus may be the site of a tumor resulting in various disorders of hormonal function. The cessation of hormone secretion from the hypothalamus is directly related to the size of the tumor. The tumor is characterized by various symptoms: headaches, neurological disorders, visual field impairment, pallor, asthenia (fatigue), absence of menstruation, hair loss, diabetes insipidus, etc. Craniopharyngiomas are rare tumors. Hypothalamic hamartomas (HH) are rare benign neural tumors that cause epilepsy, behavioral disorders and precocious puberty. Germinomas are rare malignant tumors, representing 0.5 to 2% of primary intracranial tumors but 50 to 60% of germinal tumors of the central nervous system. The age at diagnosis varies from 3 to 21 years.

3. How is the hypothalamus treated?

Treatment depends on the cause of the hypothalamic dysfunction and the signs and symptoms presented by the patient. For tumors, surgery or radiation therapy may be necessary. If hypothalamic hamartomas are symptomatic with uncontrolled seizures, surgery is recommended. Thermoablation and radiosurgery may also be used. In some cases, especially when the tumor is not progressing or is not an immediate risk, no treatment for the tumor is initiated. Instead, treatments are offered to relieve any symptoms caused by the tumor (headaches, seizures). For hormonal deficiencies, therapeutic hormone replacement is used. Nutritional counseling and certain medications may be used to regulate the patient's appetite. Delayed puberty in Frohlich's syndrome is treated in males with human chorionic gonadotropin and later with estrogen and later with estrogen-progestin. Kallmann's syndrome requires lifelong sex hormone replacement.

4. Which doctors specialize in the hypothalamus?

Doctors who specialize in the hypothalamus are endocrinologists. Endocrinologists detect and treat diseases of the endocrine glands: hypothalamus (diabetes insipidus, etc.) pituitary gland (acromegaly, prolactin adenoma, cushing's disease, adenomas, etc.) thyroid gland (goiter, nodules, hyper- and hypo-thyroidism, thyroid cancer, etc.) adrenal gland (Addison's disease, etc.) ovaries and testicles (gonadal insufficiency, hair problems, etc.). Neurologists, neurosurgeons and neuroradiologists are involved in the management of hypothalamic-pituitary pathologies.

5. What are the medical examinations of the hypothalamus?

The diagnostic work-up of hypothalamic dysfunction depends on the clinical condition, signs and symptoms of the patient. The classic workup includes hormone assays (serum cortisol, serum estrogen, pituitary hormones such as adrenocorticotropic hormone, growth hormone, thyroid stimulating hormone, luteinizing hormone, follicle stimulating hormone, prolactin), testosterone, thyroid hormones, sodium levels and blood and urine osmolality. Other diagnostic tests include pituitary MRI or CT scan (for urgent cases), visual field test, genetic analysis, autoimmune markers...

Sources :

Université Médicale Virtuelle Francophone - Dr. Chantal KOHLER, Les glandes endocrines, Collège universitaire et hospitalier des histologistes, embryologistes, cytologistes et cytogénéticiens (CHEC), support de cours 2010-2011

Encyclopédie médicale weebly - Axe hypthotalamo-hypophysaire

Science direct - Giustina A, Braunstein GD. Hypothalamic syndromes. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 10.

Science direct - Marshall JC,Eagleson CA,McCartney CR, Hypothalamic dysfunction. Molecular and cellular endocrinology. 2001 Oct 25

Semantic Scholar - Zhang S,Zhornitsky S,Le TM,Li CR, Hypothalamic Responses to Cocaine and Food Cues in Individuals with Cocaine Dependence. The international journal of neuropsychopharmacology. 2019 Dec 1

Europe PMC - Samodien E,Johnson R,Pheiffer C,Mabasa L,Erasmus M,Louw J,Chellan N, Diet-induced hypothalamic dysfunction and metabolic disease, and the therapeutic potential of polyphenols. Molecular metabolism. 2019 Sep

 Hemorrhoids are swollen, vascularized tissues in the wall of the rectum and anus that sometimes cause minor bleeding or form small blood clots. 

Hemorrhoids occur when tissues swell, weaken and pull away from the structures that support them. The result is a sac-like swelling that extends into the anal area.

Hemorrhoids only affect humans - no animals have them. They are very common - up to 86% of the population will complain of having suffered from hemorrhoids at some point, but many people often use the term for any anorectal problem, including itching. Hemorrhoids can occur at any age but are most common in people between the ages of 45 and 65 and, among younger people, in pregnant women.

Although they are commonplace, even for young, fit people, they are an embarrassing topic of conversation. They can be painful and uncomfortable, but they are usually not serious. Hemorrhoids vary in location and in the amount of pain or discomfort they cause.

Internal hemorrhoids are located inside the rectum. They do not usually cause pain, as there is no sensory nerve in this tissue. The severity of these hemorrhoids is assessed according to the size and frequency of their protrusion into the anal canal or out of the anus (a prolapse):

• Stage I where they are small and do not protrude. Minor painless bleeding may occur after passing stool;
• Stage II where the hemorrhoids may protrude during the passage of stool, but then spontaneously reappear;
• Stage III where the hemorrhoids must be replaced manually;
• Stage IV where the hemorrhoids cause prolapse - they protrude continuously and come out if pushed back into the rectum. They can cause bleeding. These hemorrhoids can be painful.

External hemorrhoids form under the skin just inside the opening of the anus. They may swell and the surrounding area may become firm and painful and turn blue or purple when thrombosed. A thrombosed hemorrhoid is hemorrhoid that has formed a clot. This clot is not dangerous and will not move around the body, but it is painful and must be drained. External hemorrhoids can be itchy and very painful, especially when passing stool. They can also form a prolapse.

Causes of external hemorrhoids

Hemorrhoids are caused by constant or repeated pressure on the rectal or anal veins. The pressure is usually caused by intense and prolonged defecation efforts. Other factors can also increase the risk of hemorrhoids, including constipation, diarrhea, lifting heavy objects, poor posture, prolonged sitting or standing, pregnancy, anal sex and obesity. Liver damage and certain food allergies can also increase the strain on the rectal veins.

Symptoms and Complications of external hemorrhoids

External hemorrhoids often cause itching, burning, or bleeding and can be painful and swollen.  They are the most common cause of bleeding during defecation.

The painless emission of a small amount of very bright red blood, which can be seen in the stool or on the toilet paper, is a sign of internal hemorrhoids because the blood is only present on the surface of the stool and does not mix. If it's just a little bleeding, it's not a big problem. If this is your first time bleeding, see your doctor confirm that it is hemorrhoids. If the bleeding continues, see your doctor because the constant loss of blood can lead to anemia, a condition in which there are not enough red blood cells to provide oxygen to the tissues.

Pay attention to pain that lasts more than a week, as well as blood loss that is accompanied by weakness, dizziness, or infection. All of these symptoms should be reported to your doctor. Also see your doctor if bleeding is not caused by passing stool, and is brownish or recurring. These could be signs of a more serious disorder higher up in the colon and unrelated to hemorrhoids.

Finally, children under the age of 12 should be referred to a doctor if they have symptoms of hemorrhoids.

Diagnosis 

Examinations for hemorrhoids always involve a digital rectal exam. The doctor puts a glove on and inserts a finger into the rectum to examine the hemorrhoids. This allows the doctor to determine if the hemorrhoids are external or internal, and to assess the stage of internal hemorrhoids. A blood test is not usually necessary.

An instrument called an anoscope or proctoscope allows the doctor to examine the internal hemorrhoids. The examination should also include a lifestyle interview. This will help your doctor identify risk factors and suggest changes.

Be sure to tell your doctor about :

• Your medical and family history of hemorrhoids and bowel conditions;
• Your medication history (the medications you have taken or are taking), especially if they include anti-coagulant agents (e.g. clopidogrel*, warfarin)*.

Treatment and Prevention of external hemorrhoids

A high-fiber diet and drinking large amounts of water can treat Stage I internal hemorrhoids and painless external hemorrhoids. These measures soften the stool and reduce constipation and straining. They also reduce inflammation of the veins. A number of over-the-counter creams, ointments, suppositories, and wipes can also reduce pain and inflammation in the anal area. These include topical hemorrhoidal preparations that contain local analgesics with soothing properties. Your pharmacist can help you choose an appropriate topical application. Prescription medications include cortisone-based anti-inflammatory creams.

Using a stool softener or stool expander to prevent constipation and 15-minute sitz baths 3-4 times a day can also help. A sitz bath consists of filling a container with warm water on the toilet seat. Cold compresses followed by warm compresses in the affected area can help dissolve blood clots if the hemorrhoid is external.

When hemorrhoids are more severe, medical attention may be required. External hemorrhoids can be removed or drained by a doctor under local anesthesia, using a scalpel, if they have formed a blood clot in the previous 72 hours.

Internal hemorrhoids, depending on their stage, may require procedures that can be performed either in the doctor's office or under surgery. A hardening agent is sometimes injected into internal hemorrhoids to decrease their volume and make them firmer. Stage I to III internal hemorrhoids can be tied with an elastic band. The blood supply is then cut off, and the hemorrhoid tissue eventually dies and falls off 5-7 days later. Hemorrhoids can also be destroyed with electric current, laser, heat, cold or infrared rays. These procedures may cause some discomfort.

A hemorrhoidectomy is a type of surgery performed under general anesthesia and allows for the complete removal of internal hemorrhoids. It is reserved for severe cases where other types of treatment have failed or have not been tolerated. Hemorrhoidectomy is characterized by the lowest rates of recurrence (return of hemorrhoids) but the highest rates of postoperative pain.

Here are some quick tips on hemorrhoid prevention:

• have a bowel movement as soon as the need arises because the fecal matter may harden;
• Avoid making intense efforts to defecate and do not sit on the toilet seat for too long;
• Drink at least 8 glasses of water a day;
• Eat high-fibre foods such as whole grains, vegetables, and fresh fruit - especially prunes and bran;
• Get plenty of exercises and don't sit for too long. Try to go for short walks;
• lose the extra weight you have.

 In order to be able to see the world around him, every human being has two eyes. But the eyes are part of a vast optical system composed of various elements that, by working together, allow us to see. In this optical system, there is the iris. This element is very important for the view.

1. Definition of the iris

The iris is a part of the optical system and, more precisely, the bulb of the eye. The iris is easily recognizable by its color, which varies from person to person.

In addition to the iris, the human eye is composed of many other structures: the cornea, the iridocorneal angle, the ciliary body, the lens, the sclera, the conjunctiva, the retina, the choroid, the vitreous and the eyelids.

The iris is one of the elements that allow a human being to see. It is located in the front of the eye, follows the choroid, and is located between the lens and the cornea. It is thanks to the small hole in the center of the iris that light can enter the eye. This opening is called the pupil. With the help of several muscles, the iris directly influences the pupil.

The iris is made up of several layers called the anterior layer, the stromal layer, the anterior epithelium, and the posterior epithelium.

2. Why is the iris not the same color in everyone?

Some people have blue eyes, and others have green or brown eyes. The color of the iris is not always the same because of the concentration of melanin in the iris. Melanin is a brown pigment found in the iris, but also in the hair or in the skin. The higher the concentration of melanin, the darker and browner the eyes. When the eyes are green, the concentration of melanin is average and when the eyes are blue, the melanin is in low quantity.

In some people, the color of the iris may not be the same from one eye to another. In fact, it is even possible for the iris of one eye to have several different colors, called heterochromia. A person can be affected by heterochromia from birth, but it can also be caused by a disease.

According to some studies, it seems that originally the first human beings all had brown eyes. But about 10,000 years ago, a genetic mutation would have made the eyes appear blue.

3. Why do almost all babies have blue eyes at birth?

It may sound strange, but most babies are born with blue eyes and then their irises change color to their final color. In reality, when a baby is born, the melanin in the iris is deep inside the eye, which is why the eyes are blue. As the weeks go by, the melanin will rise to the surface of the iris and the baby's eyes will become brown. If the melanin does not rise, the eyes will remain blue and if a low level of melanin rises to the surface, the baby's eyes will be green.

It is important to know that this phenomenon does not occur to everyone. In Asian or African babies, for example, the eyes are already dark from birth.

4. What is the purpose of the iris?

The main role of the iris is to allow the pupil to dilate or contract depending on the situation. The iris contracts the pupil with the sphincter muscle and dilates it with the dilator muscle. Thus, the iris controls the amount of light that enters the eye. When a person perceives a bright enough light, the iris in their eyes will instruct the pupils to contract so that less light enters the eyes. On the other hand, when a person perceives a dim light, the iris will instruct the pupil to dilate so that more light can enter the eye.

5. What are the diseases of the iris?

It is important to understand that eye diseases are not necessarily the same as those that can affect the iris. Here, we are only talking about pathologies affecting the iris itself and not the other structures of the human eye.

Thus, among the most frequent diseases that can affect the iris, we find iritis. This is an inflammation of the iris that is characterized by redness in the eye and pain. In addition, because of iritis, visual acuity can be reduced. Sometimes, iritis is accompanied by an inflammation of the ciliary body, which is called iridocyclitis.

Aniridia is another disease that affects the iris. In fact, it is a rare condition that affects one in 40,000 babies each year. Aniridia is a genetic malformation that affects children at birth or during childhood. This pathology is, quite simply, an absence of iris in the child who is affected. The amount of light that enters the eye is no longer controlled normally, which can be dangerous. If too much light enters the eye, it can cause damage to various structures in the eye. In addition, over time, aniridia can develop into glaucoma or cataracts.

Ocular albinism is also a disease of the iris. Specifically, it is a depigmentation of the iris and retina due to a low level of melanin. In the case of ocular albinism, the patient's iris is gray or blue in color, while the pupil has red highlights. In some cases, albinism also affects the skin and hair in addition to the iris, in which case it is called oculocutaneous albinism.

Finally, among the pathologies of the iris, we can also mention heterochromia. This is not a disease per se, but rather a physical characteristic that causes a difference in color in each iris. This is known as "vairish eyes".

6. How to treat iris diseases?

Unfortunately, there is no treatment for the different pathologies described above, which cannot be cured, except for iritis which is simply an inflammation that can be treated with medication. On the other hand, concerning aniridia, ocular albinism, and heterochromia, there is no way to cure these pathologies.

Aniridia and ocular albinism are the two most dangerous conditions, as they can worsen with prolonged exposure to sunlight or by looking at a bright light for too long. Aniridia can lead to glaucoma or cataracts, while albinism, if it also affects the skin and hair, can turn into skin cancer, among other things.

The World Health Organization (WHO) strongly recommends that people with aniridia or albinism wear sunglasses and cover their heads with a hat, but above all not go out in the sun. These recommendations are very important to avoid any risk of complications.

7. Which doctors specialize in iris?

There are no iris specialists as such, nor are there any specific medical examinations. Of course, there are many eye doctors, such as ophthalmologists, among others, but they are not necessarily able to read and understand the iris.

If the patient decides to undergo iridology (study of the iris), he or she can turn to an iridologist, a naturopath, or a homeopath. Iridology is often used in non-conventional medicine.

8. What are the medical examinations of the iris?

There are no real medical examinations of the iris since the main diseases of this structure of the eye cannot be cured. However, there is a technique used by some professionals that allows them to study the iris in order to obtain a complete health check-up of the patient. This technique is called iridology. Although there are no particular contraindications that prevent the use of iridology, no scientific study has been conducted to date to prove that this technique is really effective in making a concrete diagnosis of possible pathology.

Apart from that, we could mention biometrics (techniques for "measuring the living"). It is important to understand that each person is unique and that each iris is different. Thus, it is almost impossible to find two identical irises. Moreover, even in twins, the irises are not the same. Biometrics can, in some cases, succeed in identifying a person thanks to the recognition of his iris. Biometrics is often used in prisons, but also in customs services or in banks.

Sources :

Opticiens par conviction : qu’est-ce que l’iris : rôle et anatomie

Institut Laser Vision : qu’est-ce que l’iris ?

Pôle Vision : l’iris

 Vitiligo, a disease that causes skin depigmentation, is neither infectious, contagious nor (physically) painful. Nevertheless, it has important psychological repercussions because people who suffer from it often suffer from the gaze of others. Good news: there are adapted treatments.

1. Depigmentation of hair, face, lip, hand, eyes, arms: definition of vitiligo

Vitiligo is a skin disease that is not contagious. It is linked to a progressive depigmentation of the skin, which affects 0.5 to 1% of the world's population, according to the French National Institute for Health and Medical Research (Inserm). Men are as well affected as women by this dermatosis. It is, however, quite rare in children. The depigmentation spots can evolve and become generalized. Vitiligo is a benign skin condition. Nevertheless, it has a significant impact on the psychological health of the patient and can alter his or her quality of life. This is one of the main reasons why scientists have conducted numerous research projects on this skin disease. This development of medical research has made it possible to identify the causes of vitiligo and to better manage this disease with more effective treatments. However, morals and physical standards tend to evolve and this aesthetic and atypical difference can now be considered a real asset.

2. When does vitiligo appear: symptoms and first signs

The signs of vitiligo are very characteristic. They are plaques, also called achromia or leucoderma, because they are white in color. This depigmentation is not painful, it does not cause itching or burning. In other words, vitiligo is asymptomatic. The patches are smooth, without relief, and perfectly delimited thanks to their geometric contours.

There are several types of vitiligo:

• Generalized "vulgar" vitiligo, which is the most common form. The plaques are numerous and roughly symmetrical;
• Localized vitiligo, corresponds to the appearance of only a few patches visible only on an area of skin. They have the appearance of a band and are present only on one side of the body;
• Universal vitiligo or Universalis can affect almost all areas of the skin and hair, leaving very little of the original skin/hair color visible.

Vitiligo can take three forms:

• Segmental, which includes localized or unilateral vitiligo;
• Non-segmental, which is generalized or universal vitiligo. Generally, in the case of non-segmental vitiligo, a simple white patch appears on the face, hands, or feet. It then evolves in a very variable way from one individual to another. When vitiligo spreads, it can end up covering almost the entire body (universal vitiligo). It also happens that the patient's hair is affected, this is called leukonychia;
• Mucous vitiligo is an extremely rare form of vitiligo. It is characterized by the appearance of depigmented areas on the mucous membranes (genitals, lips, etc.).

3. What causes the disease vitiligo, which causes white spots to appear on the skin?

 Pants that are difficult to close, a feeling of swelling of the fingers when you put on a ring, legs in pole, a puffy face, a swollen belly ... These are just a few examples of the consequences of water retention. Several causes can explain it. Identifying the one that concerns you is the first step to setting up an effective routine.

What is water retention?

Water retention corresponds by definition to an accumulation of water in the tissues, particularly in the legs, which leads to a feeling of swelling and heaviness. "Normally, there is a pressure system that allows water to go out and come in. In the case of water retention, the water leaves the cells and remains in the extracellular environment," explains Dr. Toledano, phlebologist. This problem affects nearly one woman in two. "But in 90% of cases, there is no serious cause and it can be treated with appropriate hygienic and dietary measures", reassures the doctor.

>> Our body contains about 60% of water. That which comes from drinking water or food is evacuated through perspiration, breathing, and urine with mineral salts. Otherwise, two-thirds of it is in our cells and the rest is part of the extracellular liquid. The latter must circulate permanently. It follows a path that comes from the arterial capillaries to the lymphatic vessels and venous capillaries that absorb it. A perfect balance is then established: all the water that leaves the arterial capillaries must be completely reabsorbed by the venous capillaries.

"But if this circuit does not work or works poorly, the water accumulates in the cells and creates edema or water retention," says Philippe Blanchemaison, a phlebologist in Paris.

What are the causes of water retention?

Several causes can generate water retention. The vascular causes remain the most classic: "it is mainly a question of circulation problems: a fragility of the capillaries whose walls become thin and porous; a venous insufficiency, i.e. a difficulty of the veins to make go up the blood towards the heart; to which is added sometimes an insufficiency of the lymphatic circuit which, normally, helps with the reabsorption of the liquid surplus", indicates Dr. Toledano.

Other causes are possible:

Hormonal variations at the time of menstruation, pregnancy and menopause or perimenopause. A pill or a hormone replacement therapy badly dosed can make things worse.

A diet too rich in salt

A food intolerance

Localized inflammation: for example, a trauma such as a sprain with a swollen ankle.

Taking certain medications (calcium channel blockers, non-steroidal anti-inflammatory drugs, corticosteroids).

Water retention can also be caused by high levels of cortisol, the stress hormone, or a lack of thyroid hormones. Osmotic causes come from a decrease in the concentration of proteins in the blood that prevents good reabsorption of the water filtered from the arterial capillaries to the venous capillaries. This situation is more and more frequent in people who follow a vegan diet because the lack of protein in the venous blood can aggravate the phenomenon of water retention.

What are the signs of water retention?

In case of water retention, we observe the swelling of certain areas of the lower body (due to the phenomenon of gravity): the feet, the ankles, the legs but also the stomach, and sometimes even the face in pregnant women. Sometimes this swelling tends to decrease when you lie down and raise your legs.

>>Water retention in the thighs: is it cellulite? "We distinguish three forms of cellulite: watery cellulite in which water retention is the majority, adipose cellulite with a majority fatty component, and fibrous cellulite where we see fibers enveloping the fat cells, explains Dr. Toledano. In some cases, water retention can evolve into fatty then fibrous cellulite." The reason for this, in addition to giving pride of place to fruits and vegetables and limiting salt, it is strongly recommended to also reduce sugars (white sugar, jam, cakes, ice cream ...) as well as bad fats (deli meats, fried foods, cream, cheese ...).

>> Water retention: do we gain weight? Being overweight is an aggravating factor in water retention, sometimes, it is enough to lose a few kilos to stop the phenomenon.

Water retention: how to deflate quickly?

To fight against water retention, focus on aquatic physical activities: aqua gym, aqua bike or swimming, or even regular walking sessions by the water, which are very effective aids to avoid suffering from water retention. The drainage movement has beneficial effects on the phenomenon.

>> Also use compression stockings. This is not a pleasant solution during periods of high heat, but for long trips by train, plane, or car, it is a valuable aid that will protect your veins. This is especially true for pregnant women.

• Pass a jet of cold water over his legs, from the bottom to the top, at the end of the shower.
• Use a footrest if you spend a lot of time in front of your desk.
• Lie down for a few minutes, legs upright along a wall, at the end of the day.
• Massage your legs with gentle movements, going up from the ankles to the calves.
• Raise your feet from the bed.

 Are your legs swollen? Are you bothered by 1 to 2 kilos that come and go with your menstrual cycle? Don't worry: it's water! 

Diet is the key to reducing bloating caused by water retention. By focusing on certain nutrients like potassium, fiber, and other minerals, we can help the body naturally release excess water.

With fluid retention, not only do we feel like we've gained 10 pounds and move like penguins, but the fluctuating estrogen levels just before our period become even more distressing.

There are many causes of water retention: venous insufficiency, hormonal imbalance, or certain foods that send a message to the kidneys to release hormones that prevent water reabsorption. If it is important to look for the causes in order to find the appropriate treatment, we can also act by adopting an anti-swelling diet.

What foods eliminate water retention?

Dietary fiber regulates the digestive system and prevents constipation. You can fill up on grains (quinoa, millet, barley), celery, beets, and peas to reduce water retention.

Also consider asparagus, rich in diuretic nutrients and fiber. Oranges, lemons, and limes contain minerals and enzymes that stimulate the release of water by the kidneys. They are also acidic, which reduces the sodium load that causes water retention. Finally, ginger contains enzymes and minerals that naturally release excess water.

Focus on diuretic fruits and vegetables

Leeks, artichokes, zucchini, fennel, cucumbers, melons, watermelon, red fruits... Seasonal fruits and vegetables are diuretics: they are rich in potassium and fiber which contribute to elimination and diuresis.

Focus on potassium, a powerful regulator

Consumption of potassium helps regulate sodium in the body, thus reducing water retention. Foods rich in potassium include avocados, pistachios, spinach, kale, sweet potatoes, mushrooms, artichokes, fennel, Brussels sprouts, arugula, bananas, mangoes, and tomatoes, sweet potatoes, and nuts.

Eat enough protein

Any protein deficiency leads to metabolic disturbances that can lead to water retention. It is therefore recommended to eat animal (meat, fish, egg) and/or vegetable (cereals, pulses) proteins every day to cover your daily needs (0.83 g per kilo of body weight).

Which drink is effective against water retention?

Drinking tons of fluids is probably the last thing you want to do, but in fact, it helps to minimize bloating. Water aids digestion, especially when combined with fiber, and allows the body to flush out excess salt.

Although water is the most recommended drink, there are other ways to hydrate with vegetables such as cucumbers, lettuce, zucchini, radishes, celery, tomatoes, kale, eggplant, and peppers.

Fruits like watermelon are also great for preventing water retention. Although caffeine is a diuretic, it does not help reduce bloating. Alcohol, on the other hand, contains sugar that increases inflammation in the body and increases discomfort.

How to eliminate water retention quickly by reducing salt?

Salt (sodium chloride) retains liquids in the cells. When consumed in excess, it causes swelling. Therefore, avoiding salty foods helps to reduce fluid retention and improve menstrual bloating.

To reduce salt intake:

• Taste before you salt;
• Remove the salt shaker from the table;
• Use spices and herbs. Replace added salt with spices and seasonings such as garlic powder, oregano, chili powder, and dry mustard to add flavor to your dishes without causing bloating;
• Limit the salt consumed in its hidden forms: cold cuts, cheeses, prepared dishes, bouillon cubes. For the aperitif, forget peanuts, pistachios, and other exotic cocktails intended for the aperitif which are full of salt: 1 g of salt for a 40 g handful!

How to get rid of water retention naturally: tips

Reduce carbohydrates and fat

Carbohydrates like bread, white rice, and pasta retain water. Try to limit your intake of these foods. The same goes for fatty or fried foods, which contain omega-6 fatty acids, but no omega-3. You can replace them with salmon and olive oil.

Avoiding bad fats

Rather than foods rich in saturated fats (butter, cream, cold cuts...), we prefer those rich in omega-3, such as fatty fish (salmon, herring, mackerel...) and walnut oil, soybean oil, rapeseed oil, wheat germ oil (2 to 3 tablespoons per day)... These unsaturated fatty acids with anti-inflammatory properties are essential to the balance of our metabolism and the proper functioning of our defenses.

Cooking with vegetable oils

Use rapeseed, walnut, or olive oils for your dishes, and avoid peanut and palm oils which contain more saturated fatty acids. Olive oil is nutritionally interesting and can be heated without being degraded. You don't like this oil? Opt for rapeseed oil, which can be heated.

Varying legumes

Pulses (also called legumes) are full of nutrients: proteins, B vitamins, iron, magnesium... So, in addition to the classic lentils, think of red and white beans, flageolets, split peas...

Revolutionize your picnics

Chips, sausage...They are all on the list of the saltiest foods! We prefer cold meats, hard-boiled eggs, crunchy vegetables, and fresh fruit, as well as figs and raisins, which are rich in potassium and have diuretic properties.

Reconnect with naturalness

All processed products, even sweetened ones, contain salt, but also additives that could lead to intolerance, at the digestive level, responsible for retention. We prefer homemade and basic foods, and we confine prepared meals to the emergency room, checking that they contain less than 1 g per portion (400 mg of sodium).

Typical menus to fight water retention

Often hereditary, water retention can be fought by adopting good eating habits. The first of these is to eat less salt. Here is a reminder of the basic rules of the anti-puffiness diet, to put into practice with our meal ideas.

Day 1 of the anti-water retention diet

Breakfast:

• 1 tea
• 1 boiled egg wholemeal bread
• 1 cup of red fruits

Lunch :

• Herbed sea bream on slices of grilled eggplant a la plancha
• Boulgour
• 1 tablespoon of rapeseed-olive oil
• 1 slice of watermelon

Snack: 1 herbal tea

The fruit or dairy from lunch can be deferred to snack time, as can the dairy.

Dinner:

• Green bean salad, potatoes, thinly sliced chicken, tomatoes, red onion
• 1 tangy vinaigrette (raspberry vinegar)
• 1 yogurt + raspberries
• 1 herbal tea

Day 2 of the anti-water retention diet

Breakfast:

• 1 tea
• 1 plain yogurt with wheat germ + muesli + prunes and plums

Lunch:

• Rice salad + grilled sardines (or canned with olive oil) + red beans and corn + cucumber + cherry tomatoes
• 1 tablespoon of rapeseed-olive oil
• 2-3 apricots
• 1 herbal tea

Dinner:

• Iced zucchini soup with fresh goat cheese and fresh mint
• Slice of cold roast beef + green salad + vinaigrette
• Wholemeal or cereal bread
• Watermelon, fig, and pistachio compote
• 1 herbal tea

Day 3 of the anti-water retention diet

Breakfast :

• 1 red fruit rooibos
• 1 strawberry/banana/yogurt/wheat germ smoothie
• Spelt bread
• Soft butter

Lunch:

• Melon
• Marinated mussels, quinoa salad, and red peppers
• 1 cottage cheese + honey
• 1 herbal tea

Snack :

• 1 nectarine
• 1 herbal tea

Dinner :

• Artichoke + vinaigrette
• Zucchini Omelet with strips of Basque sheep
• Melon soup

Day 4 of the anti-water retention diet

Breakfast:

• 1 tea
• 1 yogurt + muesli + diced peach + cranberries/goji berries

Lunch:

• Veal grenadine with herbs
• Ratatouille
• Wholemeal bread
• 1 summer fruit salad
• 1 herbal tea

Dinner :

• Gaspacho tomato-cucumber-pepper marinated
• Pasta salad + shrimp + mesclun
• 1 cottage cheese, 20% + currants
• 1 herbal tea

What to eat and drink in case of water retention: rules to remember

Reduce your salt intake;

Drink at least 8 glasses of water a day;

Eat enough protein;

Eat enough protein; eat certain foods, especially fruits and vegetables rich in minerals and fiber, or that improve blood circulation;

We respect the acid-base balance of the body: during meals, think of associating an acidifying food (cereal, meat, fish, egg...) with an alkalizing food (fruit, vegetable, tofu, spices...) to neutralize the first one.

 Heat stroke corresponds to an overheating of the body with a temperature above 40 degrees. It is a life-threatening medical emergency. Causes, symptoms, treatment, exercise, heat, stroke, reflexes to have, risk, duration... Advice.

When it is hot, our body reacts by activating its cooling system. The objective: is to maintain the internal temperature at 37°C even if it is warmer outside. How do we do this? By vasodilatation and sweating. Vasodilatation of the vessels, which can be felt when it is hot (heavy legs, swollen hands, and feet, hot skin surface), allows heat to be evacuated to the body surface. Sweat, on the other hand, cools the surface of the skin. The problem is that in infants, these cooling mechanisms are not always perfected and that in the elderly, they no longer work as well. As a result, the youngest (especially those under 4 years of age) and the oldest risk becoming dehydrated more quickly and seeing their internal temperature exceed 37°C. Heat stroke is a life-threatening medical emergency. 

Definition: what is heat stroke?

Heatstroke corresponds to an overheating of the body with a temperature above 40 degrees. The body can no longer cope with the increase in internal temperature due to muscular activity and/or an overheated environment (heat wave). A distinction is made between classic heat stroke in people who are exposed to a hot and humid environment for a long period of time (for example, spending hours in a car or on a subway train in the middle of the heat) and exercise-induced heat stroke, which occurs after intense and sustained physical activity (classic heat stroke). Classic heatstroke occurs in epidemic form during heat waves and predominates in elderly, frail people suffering from chronic pathology: cardiovascular, pulmonary, or mental.

What is exercise-induced heat stroke?

Exercise-induced heatstroke occurs during intense and sustained physical activity in a hot atmosphere, sporadically, and affects young, healthy individuals such as elite athletes and military personnel. The symptoms are similar to classic heat stroke except that the subject's skin is moist due to heavy sweating, rather than dry.

What are the symptoms of heat stroke?

The diagnosis of classic heat stroke is based on hyperthermia and consciousness disorders after exposure to a hot and humid atmosphere. Symptoms of heat stroke include:

• a sudden fever that reaches or exceeds 40°c
• palpitations
• iolent headaches
• diffuse redness
• the skin is hot and very dry (sweating stops) / in athletes, the skin is hot and rather humid.
• vomiting
• diarrhea
• mental confusion, delirium, and severe agitation

How long does heat stroke last?

In benign forms that are quickly treated, heat stroke generally lasts less than 12 hours. 

What should you do?

You must seek medical assistance as soon as possible: call 15. In the meantime :

place the subject in the shade

cool them down by spraying them with cold water and ventilating them

or give a cold shower or bath.

No adjuvant pharmacological treatment that can accelerate cooling has been shown to be effective.

What are the risks of heat stroke?

Heat stroke is a medical emergency because it can be life-threatening. It can lead to neurological disorders (delirium, convulsions, or coma) and then to so-called "multi-visceral" failures, which can lead to death. The multi-visceral failures are :

• Cardiovascular failure: arterial hypotension, shock
• Respiratory failure: polypnea, deep hypoxemia
• Renal failure: oligo-anuria, moderate to severe renal failure.
• Hematological failure: disorders of hemostasis with thrombocytopenia, even fibrinolysis and disseminated intravascular coagulation (DIC).
• Hepatic failure (rarer).

Among the most severe complications observed following a heat stroke are:

• Acute coronary syndrome
• Heart rhythm disorders, conduction disorders.
• Hemorrhagic complications
• Acute respiratory distress syndrome (ARDS)
• Acute pancreatitis
• Fulminant hepatitis. 

How to avoid it?

1. Drink water regularly without waiting to be thirsty (at least 1.5 L per day). The first people concerned are infants and the elderly. The latter, who sometimes do not feel thirsty, must force themselves to drink.
2. Avoid physical exertion and sports that increase your body temperature.
3. Wear light, loose-fitting clothing that allows air to circulate and is light in color so as not to retain heat.
4. Cool down several times a day: don't hesitate to take showers, wet your head, or use misting machines or damp cloths.
5. Fans? They provide a pleasant sensation of freshness through the circulation of air, but when the air is hot, it stays hot and in fact, it does not cool you. So it's not enough to keep you cool. It is better to wet yourself regularly.
6. What to drink? Avoid alcohol, sugary drinks, and drinks with a high caffeine content (coffee, tea). Prefer plain and sparkling water (enriched with salt) and fresh fruit juice.
7. What to eat? Continue to eat normally, giving preference to fruits and vegetables: raw vegetable salads, fresh soups, but also dairy products (liquid yoghurts, milkshakes, etc.).
8. Cover your head. Hats, caps, or scarves can help you avoid sunstroke.
9. Even if the heat makes you tired, don't take a nap in the sun!
10. Stay in well-ventilated and cool rooms. Close the shutters and open the windows to let the air in. If your apartment is really hot, arrange to stay in cool or air-conditioned places for at least two or three hours during the day (department stores, movie theaters, public places).

Treatment and Prevention

Heat stroke is a medical emergency. Learn how to recognize the above symptoms and take appropriate action yourself. The victim of heat stroke should go to the emergency room as soon as possible, but the first step is to regain control of the internal temperature.

If you suspect that a person has suffered heat stroke, begin treating them immediately, while someone else makes an emergency call 911. The first priority is to bring the victim's temperature down immediately. The most effective solution is to move the person out of the sun and immerse them in cold water (river, stream, or bathtub). You can also help the person cool down while waiting for help to arrive by fanning him or her vigorously and giving him or her water with a warm water spray. You can also remove some of the person's clothing and apply ice water, towels, or ice packs to the groin, neck, armpits, and head. 

If the person begins to shiver, slow down your sedation method, as shivering increases the internal temperature. Take his or her temperature every 10 minutes if you have a thermometer. You should aim for a temperature of 39°C (102°F), as too low a temperature can be dangerous (hypothermia). During this time, make arrangements to take the victim to an emergency room. Be alert for signs of respiratory arrest (respiratory failure), and be prepared to perform mouth-to-mouth resuscitation if necessary.

The victim of heat exhaustion should be moved to a cool area. Lay the victim on the floor and give him or her a sip of water every two to three minutes. Sports drinks are best, but water is often the most readily available. Sponge the victim with cool water and remove any unnecessary clothing. Pay particular attention to signs of deterioration, but be aware that there is no specific urgency to take the victim to the hospital in the classic case of heat exhaustion. Symptoms usually last 2-3 hours.

To avoid this type of problem, you should drink plenty of fluids during heat waves, especially if you plan to work or play sports outdoors. If you are exercising, it is recommended that you drink about 500 ml to 1.8 L of water in the 3 hours before exercise, and add 200 ml to 250 ml every 20 minutes during the exercise itself. After exercise, fluid loss continues, so it is important to continue drinking water for several hours after exercise. Some experts advise continuing until the urine turns pale.

Do not take salt tablets unless you are also drinking plenty of water. In very hot environments, drink every hour, whether you are thirsty or not, as thirst is a late indicator of dehydration. Other prevention methods include:

• during the summer, avoid strenuous outdoor activities during the hottest part of the day (between 10 a.m. and 3 p.m.);
• Avoid being in the sun, if possible;
• If you must stay in a hot environment, take a 10-20 minute break in the shade or in an air-conditioned area for each hour of activity.
• Wear loose-fitting, light-coloured clothing (light colors reflect sunlight better) and a wide-brimmed hat;
• Try to rest in the shade during the hottest part of the day;
• Avoid coffee and alcohol, especially beer, which facilitate fluid loss.