Dr. Manie Juneja, MD, MBBS

When a patient has sufficient blood volume and lacks one or more components, a complete blood count (CBC) test can help determine if a patient requires a transfusion by measuring four blood components: red blood cells, white blood cells, platelets, and hemoglobin. If any of the patient's component counts is significantly below a standard range, the patient will likely need a blood transfusion. The complete blood count test uses a needle to extract a small amount of blood for testing.

Blood transfusion recipients should be tested for their blood type, which is one of four different types: type A, B, AB, or O. Patients with A, B, and O blood can only receive a blood donation matching their blood type or of O blood, which is known as the universal donor. Those with AB blood are considered "universal recipients"; they may receive A, B, AB, or O blood. Further complicating blood types is the presence or absence of the RhD antigen, adding a positive or negative modifier that should also be considered. Incompatible blood donations may cause transfusion sickness, such as a hemolytic reaction, where the body fights the donated red blood cells.

In certain emergency or trauma situations, medical teams often do not perform a complete blood count (CBC) test or blood type test. In those cases, patients are often given O negative blood, which is universally accepted. Some patients have their blood type on a medical card or bracelet, allowing emergency medical teams to issue compatible blood without testing.

Transfusions are performed by inserting a needle attached to an intravenous line (IV) into a vein in the body. This IV line is attached to a bag of blood that steadily dispenses blood into the patient's bloodstream. The type, volume, and components of donated blood depend on the patient's condition and needs. After the transfusion is complete, patients are generally permitted to resume normal activity, unless prohibited by a condition or injury. Some patients may experience bruising or soreness around the area that the needle was inserted.

At times, a second complete blood count test is performed to determine if the transfusion has brought patients' component counts to normal levels. Some patients may require multiple blood transfusions to reach a healthy blood volume and blood component count.

Once patients' blood volumes and components reach sufficient levels, they will generally begin to feel better. Patients of all ages, from newborn infants to elderly adults, can receive a blood transfusion.

IBS, or irritable bowel syndrome, happens when the muscles surrounding the colon contract too easily or frequently. The result is abdominal pain, cramps, diarrhea or constipation, gas and bloating. IBS attacks can often be brought on by specific triggers, so a key part of treatment is learning which foods trigger IBS attacks and avoiding them. Treatment also includes exercise, avoiding stress, and medications if needed.

Constipation, or large, hard, or infrequent stools, happens to everyone at some point. It can be caused by a disruption in routine or food, or by eating a diet without many fresh fruits and vegetables. Although it is uncomfortable, constipation is common and usually not serious, but it can sometimes become chronic. Adding fiber to the diet, exercising, and taking medications may help.

GERD, or gastroesophageal reflux disease, is a severe form of chronic heartburn where stomach acid spills back up into the esophagus. Left untreated, the acid may even eat away at the esophagus and cause serious damage. Treatment includes changing the diet to avoid trigger foods, losing weight if needed, medications, or even surgery.

Hemorrhoids are blood vessels around the rectum that become irritated, swollen or torn while straining during a bowel movement. They are most often caused by constipation, but can also be caused by pregnancy, diarrhea, or simply a genetic predisposition towards hemorrhoids. Treatment involves first treating any constipation issues, then keeping the area clean and soothed until it has healed. If these measures are ineffective, surgery is sometimes used.

Peptic ulcers are sores or spots of inflammation in the lining of the stomach or close to the stomach in the small intestine. Usually this area is coated with a protective lining that shields the tissue from the strong stomach acid, but a break in the lining can let acid in, causing the sores. It used to be thought that stress caused ulcers, but now it is known that is not the case. Most often, they are caused by an infection by H. pylori bacteria, but ulcers can also be caused by alcohol abuse or overuse of aspirin, ibuprofen, naproxen, or other NSAIDS. The symptoms of an ulcer are pain, hunger, nausea, and fatigue.

Gastrointestinal problems, perhaps more than any other area, are markedly affected by lifestyle. Many disorders can be prevented or treated at least in part by eating a healthy diet high in fiber, exercising regularly, drinking enough water, and limiting alcohol intake. Still, the frequency of digestive disorders means that even the healthiest person can be affected by them. Anyone who notices blood in their stool, experiences abdominal pain, unexplained weight loss, or any significant change in bowel movements should see a doctor.

Both injection and aspiration are techniques that involve inserting a needle connected to a syringe directly into the joint. Aspiration involves the removal of excess fluid, and injection is the placement of medication directly into the joint space via the needle. Both procedures may be performed at the same time. In both cases a local anesthetic may be used, the skin will be cleaned and disinfected, and then the needle will be inserted. In some cases, especially if the injection or aspiration is in a large and deep joint such as the hip or spine, ultrasound may be used to guide the needle to the exact location desired.

In some cases, irritation to the joint can cause fluid to build up so significantly that the joint hurts and can no longer move well. Aspiration removes some of the excess fluid and relieves the pressure. In addition, aspiration can be used to provide a sample of joint fluid if it needs to be examined microscopically for the presence of white blood cells, bacteria, or crystal formations.

Certain injuries and diseases that affect joints are inflammatory in nature, such as rheumatoid arthritis, tendonitis or gout. These diseases may be helped by the local injection of anti-inflammatory medications directly into the affected joint. In this case, corticosteroids such as methylprednisone are usually used. Relief from the pain may be felt right away and may last for weeks or even months.

In some cases, such as with osteoarthritis, the cartilage buffer between the two bones wears down and pain comes from bones rubbing against each other. In this case, injection of a lubricating agent such as hyaluronic acid may be beneficial. It provides a slippery cushion between the bones to relieve pain that can last for months.