What Happens To Your Lungs From Smoking? Things You Should Know
Introduction
You’ve probably heard of this disclaimer on multiple occasions – ‘smoking is injurious to health’. What you may not immediately realise is the extent of the damage smoking can cause to your health and, most directly, your lungs.
Smoking is known to be the leading cause of preventable diseases and deaths globally. Nearly all forms of lung cancer, the top cause of cancer death in both men and women, can be attributed to smoking. Tobacco and tobacco-related products can damage the lungs’ ability to supply oxygen to the body. Other substances commonly found in cigarette smoke can cause permanent lung damage, even in small amounts.
How Smoking Changes Your Lungs
A single puff of cigarette smoke contains upwards of 7,000 chemicals. Tobacco smoke contains over 70 known cancer-causing chemicals2. When you breathe these in, these toxins go deep into your lungs and can cause swelling, resulting in a host of other respiratory diseases.
Both tobacco and chemical substances found in cigarettes can change the cellular structure of the lungs. They can cause the elastic walls within the airways to break down – resulting in less functioning surface area in the lungs. Cigarettes can damage lung tissue, preventing them from functioning correctly. This can increase the risk of diseases caused by smoking, such as chronic bronchitis, emphysema, respiratory diseases, asthma and COPD (Chronic Obstructive Pulmonary Disease)1.
Nicotine in tobacco can also damage the ability of the respiratory system to filter out dust and dirt. This can lead to toxic substances passing through, resulting in lung congestion and the ‘smoker’s cough’.
Repercussions of Long-term Smoking
A person who smokes throughout life is at high risk of developing a range of potentially fatal diseases owing to impaired lung function and breathlessness due to swelling and narrowing of the lung airways and excess mucus build-up. They are also prone to weakening the lungs’ clearance system, leading to the accumulation of toxic substances and causing lung irritation and damage. Further, they are also at an increased risk of lung infection, chronic bronchitis and heightened risk of asthma, along with permanent damage to air sacs3.
In the longer term, smoking is known to induce heart disease and stroke, in certain cases, it can cause ulcers of the digestive system and put smokers at increased risk of type 2 diabetes.
Most smokers are also likely to develop emphysema. The number of cigarettes you smoke and other lifestyle factors may impact the extent of the damage. If you’re diagnosed with either of these respiratory diseases – emphysema or chronic bronchitis, you run the risk of being diagnosed with chronic obstructive pulmonary disease (COPD).
Beyond Lung Damage: Diseases Caused by Smoking
Smoking can affect a person’s health in other ways, too, harming almost every organ in the body. In most cases, it can result in a compromised immune system function, making you susceptible to many other illnesses. It can also lead to lower bone density (brittle bones), which increases the risk of broken bones and fractures. Smoking also leaves you at a higher risk of rheumatoid arthritis, heart disease and stroke, along with an increased risk for cataracts (clouding of the eye lenses).
Apart from respiratory diseases, other visible disorders include an increased risk of oral cancers, gum disease and tooth loss, premature ageing of the skin, bad breath and stained teeth and an increased risk for age-related macular degeneration, which can lead to blindness. Moreover, even your wounds may take longer to heal!
It’s never too late to quit smoking. Within days of quitting smoking, lungs begin to repair themselves. In fact, just 12 hours after you quit, the amount of carbon monoxide in your blood drops to a much healthier level. More oxygen flows to your vital organs and you will be able to breathe better. In about 10 to 15 years, your risk of developing lung cancer reduces and may even become the same as a non-smoker4.
References
1. Centers for Disease Control and Prevention (US); National Center for Chronic Disease Prevention and Health Promotion (US); Office on Smoking and Health (US). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2010. 7, Pulmonary Diseases. Available from: https://www.ncbi.nlm.nih.gov/books/NBK53021/
3. Varghese J, Muntode Gharde P. A Comprehensive Review on the Impacts of Smoking on the Health of an Individual. Cureus. 2023 Oct 5;15(10):e46532. doi: 10.7759/cureus.46532. PMID: 37927763; PMCID: PMC10625450. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10625450/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Links and product recommendations in the informationprovided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.
10
Colic in Babies: Meaning, Symptoms, Causes, and Effective Treatments
Introduction
If your little one cries for hours despite being fed, changed, and cuddled, you are not alone. Many parents experience this in the first few months of their baby’s life. It can be confusing and exhausting, especially when nothing seems to calm your baby down. The good news is that this phase is temporary and usually resolves on its own1.
In this blog, we will help you understand what colic is in babies, what signs to look out for, what might cause it, and the simple ways you can comfort your baby and care for yourself during this period.
What is Colic in Babies?
Colic is a common, yet puzzling condition seen in healthy babies during their first few months. It’s defined as repeated episodes of intense, inconsolable crying that lasts more than 3 hours a day, occurs on more than 3 days a week, and continues for at least 3 weeks2.
Colic usually begins when a baby is about 2 to 3 weeks old, peaks around 6 weeks, and gradually settles by about 3 to 4 months of age3.
It is very important to understand that this is not caused by poor parenting or any serious illness. In fact, colic affects up to 3 to 28% babies worldwide, regardless of whether they’re breastfed or formula-fed3.
Cry suddenly, intensely, and for no clear reason (often in the late afternoon or evening)
Have a high-pitched cry and look flushed or tense
Curl up their legs, clench fists, and tighten their tummy muscles during crying spells
Commonly present with abdominal distension during a colic episode
Sometimes pass gas or have a bowel movement near the end of the episode
These episodes can last anywhere from a few minutes to several hours, and during these, your baby may be hard to soothe despite your best efforts.
What Causes Colic in Babies?
The exact cause of colic is not fully understood, which is what makes it so confusing for parents. However, an important thing to understand is that it is not your fault, and in most cases, it is not a sign of any serious illness. It is usually triggered by a combination of factors involving the baby’s digestion, development, and environment.
Here are some of the possible reasons your baby may have colic4:
Tummy Troubles (Gastrointestinal Factors): Many babies with colic seem to have tummy discomfort. Some possible digestive factors include:
Gas or bloating: Some babies may swallow air while crying or feeding, leading to gas buildup and discomfort.
Sensitivity to milk proteins: In rare cases, babies may react to proteins found in cow’s milk or even to certain foods in a breastfeeding mother’s diet (like dairy, onion, or broccoli).
Lactose intolerance: Some infants may temporarily have trouble digesting lactose, the sugar in milk, leading to gas and fussiness.
Feeding-Related Issues: Feeding techniques might sometimes exacerbate colic. Overfeeding, underfeeding, feeding too quickly or an imbalance between foremilk and hindmilk ingestion, may all contribute to stomach discomfort and colic.
Hormonal Factors: Certain hormones in the baby’s gut, such as motilin and serotonin, may affect digestion and gut movement. Higher levels of these hormones could sometimes make a baby’s tummy more active and sensitive, leading to colicky behaviour.
Normal Brain and Emotional Development: Colic may simply be part of normal baby development. As newborns are still adjusting to life outside the womb, lights, sounds, hunger, and tiredness can all be overwhelming.
Family or Emotional Factors: Babies are sensitive to the world around them. Family stress, parental anxiety, or postpartum depression can sometimes contribute to longer crying spells in babies, though they don’t cause colic directly.
Remember: Colic does not mean you are doing something wrong as a parent. It is a common, temporary phase, and with support and patience, it passes.
Risk Factors for Colic
While colic can happen to any baby, certain factors may make it more likely. Babies with the following characteristics had a higher chance of developing colic1,3,5:
Younger age (under 5 months): Colic almost always appears in babies between 2 weeks and 4 months of age and typically improves by 3 to 4 months. It is very uncommon after 5 months.
Feeding with cow’s milk–based formula: Some babies may be sensitive to cow’s milk proteins, which might contribute to gas or discomfort.
Preterm birth: Babies born before full term are more likely to have colic.
Low birth weight: Smaller babies might be more prone to newborn colic symptoms.
Firstborn status: Colic may be more common in firstborn babies, possibly due to parental stress or feeding adjustments.
Maternal atopy (allergies): Babies born to mothers with allergic conditions such as asthma, eczema, or hay fever could have a higher risk.
Persistent nausea during pregnancy: Mothers who experience ongoing nausea might be more likely to have babies with colic.
Postpartum depression: High levels of maternal depressive symptoms after delivery are sometimes strongly associated with infant colic.
Others: Factors such as maternal anxiety and habits like smoking may indirectly contribute to colic. Poor feeding techniques may also increase the risk.
Diagnosing Colic
Colic is a clinical diagnosis based on a detailed history and physical exam to rule out other causes of excessive crying. The doctor reviews the infant’s feeding, stooling, sleeping patterns, and growth chart, and observes crying behaviour if possible.
Typical colic presents as sudden, high-pitched crying with abdominal discomfort, but the baby otherwise appears healthy and gains weight normally.
Abnormal findings suggesting other causes include a bulging fontanelle, thrush, otitis media, hernia, testicular torsion, blood in stools, diaper rash or signs of obstruction, infection, or injury.
Recurrent, prolonged crying or irritability without an identifiable cause
No fever, poor weight gain, or illness
If the exam is normal, no lab tests or imaging are needed. Additional evaluation is done only if symptoms suggest sepsis, reflux, cow’s milk allergy, or other medical conditions.
Complications of Colic
Although infantile colic is self-limiting, it can have several emotional and behavioural consequences for both infants and caregivers. Here are some possible effects of colic3,6,7:
Distressing: Although self-limiting, colic can be highly stressful for caregivers.
Overfeeding: Not knowing the exact reason for crying spells can lead to frequent and unnecessary feeding.
Sleep deprivation: Lack of sleep in parents can lead to stress and loss of efficiency.
Parent–infant bonding issues: Persistent crying may strain the emotional bond and lead to early breastfeeding cessation.
Behavioural associations: Children with infantile colic may later develop preschool adaptive difficulties and behavioural problems.
Long-term risk: Infants with colic may have a higher likelihood of developing migraine by adolescence.
Severe consequence: Heightened risk of shaken baby syndrome (excessive violent shaking leading to brain damage) due to caregiver frustration and attempts to stop excessive crying8.
Infantile Colic Treatment and Management Options
Infantile colic usually resolves on its own, but various comforting and feeding strategies could help soothe the baby and support caregivers during this stressful period. While no single remedy works for every infant, caregivers may try different infantile colic treatment approaches to see what helps.
1. Comforting Techniques
Put baby in prone position.
Hold or cuddle your baby frequently to provide reassurance.
Rock your baby gently in your arms, a crib, or a stroller.
Swaddle your baby snugly in a soft blanket.
Sing or talk softly to your baby.
Use white noise (fan, vacuum, or soft music) to create a calming background.
Take your baby for a car ride or a gentle walk in a stroller.
Offer a pacifier for sucking comfort.
Place a warm towel on your baby’s abdomen for relief1,9.
2. Feeding and Positioning Tips
Keep your baby upright during and after feeds to reduce air swallowing.
Burp your baby frequently during and after feeding.
If breastfeeding, allow the baby to finish one breast before switching to ensure intake of hind milk, which is more soothing and satisfying.
For babies who overfeed or seem uncomfortable, offer one breast over a 2-to-3-hour period.
Avoid overfeeding or fast bottle feeding; feeding sessions should last around 20 minutes1,3.
3. Formula and Dietary Adjustments
Image Source: freepik.com
Some infants may be sensitive to cow’s milk protein. A trial of hypoallergenic or hydrolysed formula after consulting your doctor may help in such cases3.
If breastfeeding, mothers may try eliminating dairy, caffeine, or chocolate for a few weeks.
Lactase enzyme drops before feeding may help if lactose intolerance is suspected.
4. Caregiver Support
Take breaks, place the baby safely in a crib, and step away briefly if overwhelmed1.
Seek guidance from a health visitor, paediatrician, or lactation consultant.
Remember: Colic does not indicate illness and usually resolves by 3 to 4 months of age1,3.
Prevention Strategies
While colic cannot always be prevented, certain feeding practices and lifestyle adjustments might help reduce its occurrence or severity1,3:
Ensure proper feeding technique: Keep the baby upright during feeding and burp often to minimise air swallowing.
Avoid overfeeding: Feed on demand and at a calm, steady pace.
Use appropriate bottle nipples: Choose a slow-flow nipple to prevent fast feeding and air intake.
Maintain a calm environment: Avoid overstimulation by dimming lights, reducing noise, and maintaining a soothing routine.
Monitor maternal diet (if breastfeeding): Limit caffeine, dairy, nuts, and gas-producing foods if colic symptoms appear.
Avoid certain medications: Consult a doctor about drugs that may pass into breast milk.
Identify formula sensitivities: If formula-fed, discuss switching to hypoallergenic or lactose-free formula with your doctor.
Encourage bonding and responsiveness: Holding and responding promptly to your baby’s cues may reduce fussiness.
Educate and support caregivers: Providing reassurance and practical coping strategies can prevent frustration and reduce stress.
With time, patience, and proper support, colic typically resolves spontaneously by 4 to 5 months, leaving no lasting effects on the child’s health or development.
Infantile colic is a common, benign (not harmful), and self-limiting condition, yet it can cause significant distress for both infants and caregivers. While its exact cause remains unclear, factors such as feeding patterns, gut microbiota, and parental stress may contribute. Thus, early recognition, reassurance, and supportive care are key to management.
In most cases, newborn colic symptoms resolve by 3 to 4 months of age without long-term effects. However, persistent or severe crying should prompt medical evaluation to exclude underlying illness. Keep in mind that providing emotional support to caregivers is equally important to ensure the well-being of both the baby and the family.
There is no clear evidence that colic is genetic. However, some studies suggest that a family history of migraine may increase the likelihood of colic in infants11.
Are colic drops safe for newborns?
Colic drops, such as those containing simethicone, are generally considered safe for short-term use in newborns when used as directed. However, they may not work for all babies, and it is best to consult a paediatrician before starting any drops.
Can breastfed babies get colic?
Yes, breastfed babies can develop colic. It is not related to the type of feeding but may be influenced by factors such as an imbalance between foremilk and hindmilk, swallowed air, maternal diet, or the baby’s immature digestive system1,4.
What is the 3-3-3 rule for colic?
The “Rule of 3” (or 3-3-3 rule) describes colic as crying for more than 3 hours a day, at least 3 days a week, for 3 weeks or longer in an otherwise healthy, well-fed baby3.
Banks JB, Rouster AS, Chee J. Infantile Colic. Treasure Island; [Internet]. StatPearls Publishing; [cited 2023 Oct 29]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518962/
Mai T, Fatheree NY, Gleason W, Liu Y, Rhoads JM. Infantile Colic: New Insights into an Old Problem. Gastroenterol Clin North Am. 2018 Dec;47(4):829-844. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6659398/
Switkowski KM, Oken E, Simonin EM, Nadeau KC, Rifas-Shiman SL, Lightdale JR. Early-life risk factors for both infant colic and excessive crying without colic. Pediatr Res. 2025 Apr;97(5):1537-1545. Available from: https://pubmed.ncbi.nlm.nih.gov/39242932/
Zeevenhooven J, de Bruin FE, Schappin R, Vlieger AM, van der Lee JH, et al. Follow-up of infants with colic into childhood: Do they develop behavioural problems? J Paediatr Child Health. 2022 Nov;58(11):2076-2083. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9804625/
Sillanpää M, Saarinen M. Infantile colic associated with childhood migraine: A prospective cohort study. Cephalalgia. 2015 Dec;35(14):1246-51. Available from: https://pubmed.ncbi.nlm.nih.gov/25754178/
Barr RG. Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers. Proc Natl Acad Sci U S A. 2012 Oct 16;109 Suppl 2(Suppl 2):17294-301. Available from: https://pubmed.ncbi.nlm.nih.gov/23045677/
Emami F, Kamrani K, Khosroshahi N. Association between maternal migraine and infantile colic: a narrative review. BMC Pediatr. 2025 Aug 4;25(1):591. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12320377/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Links and product recommendations in the informationprovided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.
Why Your Baby Isn’t Sleeping and How to Help Them Sleep Through the Night
Introduction
Sometimes your little one’s sleep pattern may seem unpredictable. Despite the late-night rocking and the endless lullabies, your baby just wouldn’t sleep through the night, leaving you stressed and exhausted. You know this is temporary, and you’re living with the hope that soon your child would finally sleep long enough, but the current phase seems endless!
Well, research shows that sleep patterns in infants and young children vary widely across ages, with newborns sleeping in short stretches and older babies gradually settling into longer, more consolidated sleep1. For instance, infants typically sleep about 12 to 16 hours a day, while toddlers average around 11 to 14 hours, but how and when those hours happen can differ greatly from one child to another2.
In this article, we will try to answer some common questions related to this topic like why my baby is not sleeping deeply and how to make my baby sleep better. We will also explain how you can recognise early signs before overtiredness sets in, and share some simple, comforting strategies that can help your little one sleep comfortably for longer periods.
Understanding Your Baby’s Sleep Needs
Sleep is one of the most essential functions of life, especially during infancy, when rapid growth and brain development are taking place. From the time a baby is born, sleep plays a vital role in supporting healthy physical, emotional, and cognitive development3.
Newborns and young infants spend much of their day sleeping, though their sleep is often fragmented and occurs in short cycles4. In the early weeks of life, babies do not yet have an established circadian rhythm, meaning they are not able to differentiate much between day and night. However, by around 10 to 12 weeks of age, the first signs of a regular sleep–wake cycle begin to appear, and many babies gradually start sleeping for longer stretches at night3.
Experts like the National Sleep Foundation (NSF) recommend the following sleep durations as general guidelines5:
Newborn baby sleeping time(0 to 3 months): 14 to 17 hours per day
Infants sleeping time (4 to 11 months): 12 to 15 hours per day
Toddlers’sleeping time (1 to 2 years): 11 to 14 hours per day
Preschoolers’sleeping time (3 to 5 years): 10 to 13 hours per day
Ultimately, your baby’s sleep needs are unique and evolve quickly during the first few years of life. Therefore, if you are wondering why my baby is not sleeping deeply, understanding these natural changes can help you respond more confidently to your baby’s cues and create gentle, effective sleep routines.
Why Your Baby Might Not Be Sleeping Well?
Sleep disturbances are a normal part of infancy, and every baby’s sleep pattern is different. Some babies sleep for long stretches, while others wake frequently during the night, and both can be completely normal.
Here are some of the most common reasons:
Hunger or Growth Spurts: In the first few months, babies need to feed often, including at night. During growth spurts (when your child rapidly increases in height and weight), babies may wake more frequently to feed as their bodies demand extra energy6.
Discomfort: A wet diaper, being too hot or too cold, or even tight clothing can make it hard for your baby to settle7.
Medical Illness: Medical reasons a baby won’t sleep include issues like teething, gastric reflux, nasal obstruction, or a cough amongst others, which can cause discomfort and lead to frequent night-time waking7,8.
Overtiredness: Babies who stay awake for too long become overtired, making it harder for them to fall asleep or stay asleep7.
Physiologic Conditions: Presence of neonatal reflex like startle reflex can make it difficult for the baby to fall asleep9.
Overstimulation: Loud noises, bright lights, or too much play before bedtime can make it difficult for your baby to wind down10.
Changes in Environment or Routine: Travel, new surroundings, or even a change in caregivers can temporarily disrupt your baby’s sleep11.
Separation Anxiety: Many babies experience separation anxiety. They may resist sleep or cry when you leave the room because they feel distressed12.
Note: Remember, occasional sleep struggles are part of normal development. With patience, gentle reassurance, and a consistent routine, most babies eventually learn to sleep for longer stretches as they grow. However, in some cases medical illnesses may be the cause of sleep disturbances. They need to be evaluated thoroughly and managed appropriately.
Recognising Your Baby’s Tired Signs
Every baby has their own way of showing when they are ready for sleep. Thus, learning to spot these cues can make a big difference in helping your baby settle more easily and avoid becoming overtired. In the first few months, babies tire quickly13.
Newborns (0 to 3 months): May show tired signs after being awake for just 30 minutes.
Babies (3 to 6 months): Often start getting tired after 1.5 to 3 hours of wakefulness.
Note: Sometimes, babies may show similar cues when they are bored (for example, staring or fussing). In those cases, a gentle change of activity or environment can help. But if your baby has been awake for a while and starts showing multiple sleepy cues, it’s best to create a calm environment and help them drift off to sleep before overtiredness sets in13,14.
Practical Ways to Help Your Baby Sleep Better & Quicker
Every baby is different, but most can be gently guided toward better sleep with a mix of routine, comfort, and consistency. So, if you want to know how to make a baby sleep, here are some practical ways to help your little one sleep more peacefully.
1. Maintain Regular Sleep Patterns
Establish a consistent bedtime and wake-up routine to help your baby develop healthy sleep habits and feel secure13.
2. Separate Feeding from Sleep
After a feed, enjoy brief playtime (like cuddles, floor play, or a short walk) so your baby does not always fall asleep right after feeding. This helps prevent a strong feed–sleep association that can lead to frequent night wakings15.
3. Watch for Tired Cues
Yawning, rubbing eyes, or becoming fussy are early signs that it’s time to sleep. Try settling your baby before they become overtired14.
4. Encourage Short Naps
Offer 2 to 3 naps a day, each around 1 to 2 hours. Avoid very long or late-afternoon naps, which can disrupt night-time sleep14.
5. Maintain Proper Sleeping Posture
Image Source: freepik.com
Always place the baby on their back on a firm, flat surface for safe sleep. Neck should be well supported while keeping baby down16.
6. Swaddle Safely
If your baby cannot yet roll over, wrapping them snugly can provide comfort. Ensure the swaddle allows free chest and hip movement and stop swaddling once rolling begins13.
7. Create a Day-Night Rhythm
Keep the daytime environment bright and interactive. At night, dim lights, lower noise, and keep feeds calm and quiet to signal it’s sleep time15.
8. Use Calming Sounds and Cues
Soft singing, lullabies, or white noise can help some babies relax13.
9. Keep Bedtime Predictable
Image Source: freepik.com
A warm bath, gentle massage, and dim lights can make bedtime calm and reassuring13.
10. Promote Self-Settling
While holding or rocking is comforting, gradually letting your baby fall asleep in their own space can support better sleep habits over time14.
Parenting through sleepless nights can be exhausting, and your well-being matters, too. So, don’t forget to look after yourself15:
Rest whenever possible, even during the day.
Ask for support from family or friends.
Safe Sleep Guidelines for Babies
Creating a safe sleep environment is one of the most important steps you can take to protect your baby. The Center for Disease Control and Prevention (CDC) supports the 2022 American Academy of Pediatrics (AAP) recommendations for safe infant sleep. Here’s how you can help reduce the risk of sleep-related infant deaths, including Sudden Infant Death Syndrome (SIDS)16:
Always place your baby on their back (Supine position) for all sleep times, for both naps and nighttime.
Use a firm, flat sleep surface, such as a mattress in a safety-approved crib or bassinet, covered only with a fitted sheet. Avoid inclined or soft surfaces.
Share the room, not the bed. Keep your baby’s crib or bassinet in the same room where you sleep, ideally for at least the first 6 months.
Keep soft items and loose bedding out of the sleep area. Avoid blankets, pillows, crib bumpers, and soft toys, which can pose suffocation risks.
Avoid overheating. Dress your baby in light sleep clothing and never cover their head during sleep. Signs your baby may be too hot include sweating or a warm chest.
Avoid smoking, nicotine exposure, alcohol, and illegal drugs during pregnancy and after birth.
When to Seek Help for Sleep Issues?
While sleep challenges are common in babies, sometimes persistent problems may need extra attention. You should consider speaking with your paediatrician or a child sleep specialist if13,15:
Your baby has trouble falling or staying asleep most nights (even with a consistent routine).
Sleep issues are causing excessive fussiness, day-time sleepiness, poor feeding, or developmental concerns.
You notice sudden changes in sleep patterns not linked to growth spurts, teething, or illness.
You feel overwhelmed, anxious, or sleep-deprived and need guidance or support.
Keep in mind that early intervention can make a big difference, both for your baby’s rest and your own peace of mind. A doctor can help rule out underlying medical issues, provide practical sleep strategies, and support your baby’s healthy development.
Sleep challenges are a normal part of your baby’s growth and development. From recognising tired cues and establishing a calming bedtime routine to creating a safe, nurturing sleep environment, each small step helps your baby learn when and how to rest. Remember, there’s no one “right” way to help your baby sleep; what matters most is finding what works best for your family. Be patient with yourself and your little one as you navigate sleepless nights and ever-changing routines. Over time, consistent habits, gentle reassurance, and a safe sleep space will lead to better rest for everyone.
Frequently Asked Questions (FAQs)
How many hours should my baby sleep each day?
Newborns (0 to 3 months) typically sleep 14 to 17 hours a day, waking every few hours to feed. By 4 to 6 months, babies usually sleep 12 to 16 hours, including 2 to 3 daytime naps. From 6 to 12 months, most need around 11 to 14 hours of total sleep with longer night stretches5. Remember, every baby is different; some may sleep a little more or less and still be healthy.
Why does my baby wake up crying at night?
Night waking is completely normal in infants. Common reasons include6,12: Hunger or a growth spurt Needing comfort or reassurance Discomfort (wet diaper, too hot or cold, teething or medical illness like blocked nose or gastric reflux) Overtiredness or overstimulation before bed As your baby grows and learns to self-soothe, t
How can I make my baby sleep longer at night?
To help your baby sleep comfortably at night, here’s what you can do13,15: Establish a consistent bedtime routine (bath, massage, lullaby, dim lights). Keep nighttime quiet and dark to help them learn the difference between day and night. Encourage daytime play after feeds and short naps to avoid overtiredness. Put your baby down drowsy but awake so they learn to fall asleep on their own.
Should I feed my baby every time they wake up?
Newborns may need frequent feeds, including at night. But as babies grow, not every waking means hunger. Therefore, try to check other causes first, such as comfort, diaper, or temperature6,7. If your baby settles without feeding, they may not need it. However, always follow your paediatrician’s advice, especially for newborns or if your baby isn’t gaining weight as expected.
References
Galland BC, Taylor BJ, Elder DE, Herbison P. Normal sleep patterns in infants and children: a systematic review of observational studies. Sleep Med Rev. 2012 Jun;16(3):213-22. Available from: https://pubmed.ncbi.nlm.nih.gov/21784676/
Tham EK, Schneider N, Broekman BF. Infant sleep and its relation with cognition and growth: a narrative review. Nat Sci Sleep. 2017 May 15;9:135-149. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5440010/
De Beritto TV. Newborn Sleep: Patterns, Interventions, and Outcomes. Pediatr Ann. 2020 Feb 1;49(2):e82-e87. Available from: https://pubmed.ncbi.nlm.nih.gov/32045487/
Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National Sleep Foundation’s updated sleep duration recommendations: final report. Sleep Health. 2015 Dec;1(4):233-243. Available from: https://pubmed.ncbi.nlm.nih.gov/29073398/
Seo WH, Park M, Eun SH, Rhie S, Song DJ, Chae KY. My child cannot breathe while sleeping: a report of three cases and review. BMC Pediatr. 2017 Jul 18;17(1):169. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5516313/
Quante M, McGee GW, Yu X, von Ash T, Luo M, Kaplan ER, et al. Associations of sleep-related behaviors and the sleep environment at infant age one month with sleep patterns in infants five months later. Sleep Med. 2022 Jun;94:31-37. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10315002/
Scher A. Maternal separation anxiety as a regulator of infants’ sleep. J Child Psychol Psychiatry. 2008 Jun;49(6):618-25. Available from: https://pubmed.ncbi.nlm.nih.gov/18341549/
Centers for Disease Control and Prevention. Safe sleep for babies: Reduce the risk of SIDS and other sleep-related causes of infant death [Internet]. CDC; [cited 2025 Oct 28]. Available from: https://www.cdc.gov/sudden-infant-death/sleep-safely/index.html
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Links and product recommendations in the informationprovided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.
Blue Baby Syndrome in Infants: Causes, Symptoms & Treatment
Introduction
Blue Baby Syndrome is a condition where an infant’s skin, lips, or nails appear bluish because the blood cannot carry enough oxygen. This can happen from birth (congenital) or develop later (acquired) in life. In this condition, haemoglobin (the oxygen-carrying part of red blood cells) gets converted into methaemoglobin, which cannot deliver oxygen efficiently to the tissues and leads to the bluish skin colour. Babies under six months are especially vulnerable to this because their organ systems are still developing.
It is important for parents to understand this condition because early detection can prevent serious complications such as breathing difficulties or loss of consciousness. If left untreated, reduced oxygen supply to the brain and other vital organs can quickly make the condition life-threatening. By knowing the warning signs, causes, and available treatments, parents can respond quickly and ensure their baby receives the right care1,2.
What Is Blue Baby Syndrome?
Blue Baby Syndrome, also called infant methemoglobinemia, happens when a baby’s blood cannot carry enough oxygen to the body. This is because normal haemoglobin in red blood cells changes into methaemoglobin, which cannot transport oxygen like regular haemoglobin does. Even if the baby is breathing normally, the body’s tissues and organs may not get enough oxygen. In healthy blood, haemoglobin picks up oxygen from the lungs and carries it to all parts of the body. In Blue Baby Syndrome, some haemoglobin becomes methaemoglobin and loses its ability to carry oxygen. Babies are more sensitive to this because their red blood cells are still developing, and they have lower levels of certain enzymes that can convert methaemoglobin back into normal haemoglobin.
When enough haemoglobin is affected, the body receives less oxygen than it needs. This is why the lips, skin, and sometimes nails can turn blue or purple. The colour change is a sign that oxygen delivery is reduced, which can affect important organs like the brain and heart if it continues for too long. The main issue in Blue Baby Syndrome is not with breathing itself but with the blood’s ability to carry oxygen properly. This can affect organs such as the brain and heart if oxygen delivery remains low for a long period1,3.
Since Blue Baby Syndrome carries serious risks, we need to understand what causes it and address it early to prevent serious problems for the baby.
What Causes Blue Baby Syndrome?
Blue Baby Syndrome is caused by various factors, and each cause plays a role in reducing the amount of oxygen reaching the baby’s body. These are:
1. Heart Defects
Blue Baby Syndrome in infants is mainly caused by congenital heart defect, where a baby is born with a heart problem. This means the heart did not form normally before birth. Because of this, oxygen-rich blood and oxygen-poor blood may mix, or less blood may reach the lungs to pick up oxygen. Both situations lower the amount of oxygen reaching the body. A common example is Tetralogy of Fallot (TOF). This includes four heart issues together:
Prolonged hole between the two lower chambers of the heart (ventricles),
Blockage in the blood flow to the lungs,
Main artery of heart (aorta) sitting in the wrong position, and
Thickening of the heart muscles.
These changes reduce oxygen delivery and can make the baby’s skin look bluish1.
2. Nitrate Contamination in Water and Food
Another important reason babies can get Blue Baby Syndrome is when drinking water has too many nitrates. These come naturally from rain, plants, or animal waste, but the main problem is from chemical fertilisers, manure, or human and industrial waste. When there is too much nitrate, it can seep into wells, especially in villages where people use well water for drinking or making baby formula. If a baby drinks formula made with this water, the nitrates can change into nitrites, which stop the blood from carrying oxygen properly. Babies are more at risk because their blood had more affinity towards nitrates, their bodies are small, their digestive systems and enzymes are still developing, and they cannot handle this change well. Since nitrate contamination is not visible, the only way to know if water is safe is by testing it regularly3,4.
3. Respiratory Conditions
Breathing problems can also cause Blue Baby Syndrome because they stop enough oxygen from reaching the blood. Some babies are born with blocked airways, such as choanal atresia (back of the nose is closed), Pierre Robin sequence (small jaw pushes the tongue back), laryngomalacia (soft voice box that collapses while breathing), tracheal stenosis (narrow windpipe), vocal cord paralysis (voice box does not move), or vascular rings (blood vessels pressing on the windpipe). Lung problems like pneumonia (lung infection), lung malformations (abnormal lung growth), underdeveloped lungs or conditions like Respiratory Distress Syndrome can also reduce oxygen saturation. Unlike nitrates, these problems do not change the blood itself but make it harder for oxygen to reach the blood, causing the baby to look blue5.
4. Rare Blood Disorders
When the baby is born with a weak or missing enzyme called CYB5R or with a special type of haemoglobin called haemoglobin M, these changes stop the blood from carrying enough oxygen. In one form, only the red blood cells are affected, while in a more serious form, all the body’s cells are affected. Because the blood cannot deliver enough oxygen, the baby’s body may not get enough oxygen for normal functioning6.
These conditions lower the amount of oxygen reaching the baby’s body. As a result, certain signs and changes in the skin, lips, and nails often appear, which help identify Blue Baby Syndrome.
Symptoms of Blue Baby Syndrome
Symptoms of Blue Baby Syndrome can appear in different ways depending on how much oxygen the baby’s blood is carrying. Normally, only a tiny part of the blood has methaemoglobin, about 1%. If this increases, the blood cannot carry enough oxygen, and the baby starts showing signs like:
Mild colour change (3–15% methaemoglobin): Skin, lips, or nails may look pale, grey, or slightly blue.
Noticeable bluish colour (15–20%): Bluish tint, especially around lips and hands, may be seen even if the baby seems fairly normal.
Breathing and activity changes (25–50%): Rapid breathing, weakness, irritability, trouble feeding, or unusual sleepiness may appear. Older children may have headaches, chest discomfort, or a fast heartbeat.
Severe oxygen shortage (50–70%): Irregular heartbeats, confusion, seizures, or coma can occur.
Critical levels (>70%): In this stage, life-threatening situations may develop, and urgent care has to be given.
Even a small rise in methaemoglobin can make the baby’s skin look bluish, which is called cyanosis. Cyanosis can occur when methaemoglobin reaches 1.5 g/dL compared to 5 g/dL of normal deoxygenated haemoglobin, showing the body is not getting enough oxygen1,7.
Detecting signs early and restoring oxygen can help prevent serious complications in the baby.
Diagnosis
Blue baby syndrome cannot be confirmed just by looking at a baby’s skin colour. A proper medical check-up is needed. Doctors begin with a physical examination (a careful body check-up), checking the baby’s skin, lips, and tongue for bluish colour. They also listen to the heart and lungs (breathing organs) and look for signs of trouble such as rapid breathing (very fast breathing), nasal flaring (widening of the nose while breathing), or chest retractions (chest pulling in while breathing). These help them understand if the problem is linked to the heart, lungs, or blood1,3.
Doctors may use a pulse oximeter (a small clip device put on finger or toe) to measure oxygen in the blood. If oxygen is low, they may order an arterial blood gas (ABG) test (a blood test to check oxygen and carbon dioxide levels). If methemoglobinemia is suspected, it can be detected by ABG along with other special tests like co-oximetry (a test that measures different forms of haemoglobin) or a direct methaemoglobin test can confirm it.
When heart defects are suspected, doctors may suggest a chest X-ray (picture of chest), electrocardiogram/ECG (a test to check heartbeats), or echocardiogram (heart scan using sound waves). These tests show how the heart is working and whether blood is flowing normally1,6.
It is important to remember that only a doctor can confirm the diagnosis. Parents should seek care quickly if their child shows blueness or breathing problems.
Treatment Options
The treatment of blue baby syndrome depends on the underlying issue (main reason for the blueness). Doctors carefully assess the cause of the problem and then decide on the safest treatment.
1. Heart-related causes
When the blueness is due to a heart defect (a problem in the structure of the heart), babies may be given medicines like prostaglandins (medicines that help keep certain blood vessels open) soon after birth. This allows more oxygen-rich blood to reach the body. Many babies will also require oxygen therapy (extra oxygen supply through a mask or tube) to improve breathing. In most cases, surgery (an operation to repair the heart problem) is needed during infancy so the baby’s heart can pump blood effectively1,3.
2. Blood-related causes
If blue baby syndrome is caused due to nitrate poisoning (exposure to contaminated water or food), the treatment is different. The main medicine used is methylene blue (a hospital injection that helps blood carry oxygen properly again). In cases where methylene blue cannot be used, such as in babies with G6PD deficiency or those who react badly to the medicine, vitamin C (ascorbic acid) can help lower methaemoglobin and restore normal oxygen levels in the blood. Babies usually recover quickly once this is given. In mild cases, removing the contaminated source of water or food is often enough, as the blood slowly returns to normal within a few days1,3,10.
3. Respiratory aid and supportive care
For babies with lung problems causing cyanosis (bluish skin or lips), doctors may help the baby breathe using assisted ventilation if there is trouble breathing. Oxygen can be given through a nasal tube (nasal cannula) or a small hood over the head. The oxygen amount is carefully controlled to keep blood oxygen at a safe level (around 90–95%).5 In very severe cases, rarely, doctors may use treatments such as exchange transfusion (replacing some of the baby’s blood with healthy blood) or provide high-flow oxygen (a stronger supply of oxygen in emergencies). These are only done in a hospital under strict medical supervision1,3.
It is very important to remember that treatment is always chosen carefully for each baby’s condition. Parents should never attempt home remedies or give medicines on their own. Only trained doctors can decide the correct treatment and ensure the baby’s safety.
Prevention & Parental Care
Blue baby syndrome may be prevented by safe water use, careful feeding, and proper maternal care during pregnancy. These measures help lower the chance of the condition in infants.
1. Safe drinking water
Formula for babies should be prepared only with water tested safe for nitrates. Private wells need yearly testing for nitrates and other impurities. If nitrate levels are higher than 10 mg/L, the water is unsafe for preparing infant formula or food4,11. In such cases, it is safer to use bottled water, public water supply, or deeper wells that usually have lower nitrate levels. Boiling water does not remove nitrates and may make the problem worse by concentrating them2,4.
2. Prenatal and maternal care
Regular check-ups during pregnancy may help to find early risk for blue baby syndrome, like heart problems. Folic acid tablets help in the baby’s brain and heart growth. Smoking, alcohol and second-hand smoke reduce oxygen for the baby. Rubella vaccine before pregnancy lowers the chance of a baby’s heart defect. Good sugar control in the mother with diabetes also reduces the risk of the blue baby problem1.
Following the above-mentioned can provide initial protection against blue baby syndrome. Parents also need to recognise warning signs in the baby and take them to the doctor on time.
Blue baby syndrome is rare but can become serious fast. Understanding causes like heart problems, nitrate in water, blood or lung issues helps parents take care. Using safe water for formula, and proper care during pregnancy can lower the risk. Yet, it’s important to watch out for warning signs like blue skin, hard breathing, or excessive sleepiness if a child is unwell. Parents should take the baby to a doctor immediately when these signs appear so the baby can get the right treatment in hospital and stay safe. Being aware and following the care measures properly can help prevent serious problems and protect your baby’s health.
What is the blue baby syndrome caused by in water?
It mostly comes from nitrate in drinking water. These nitrates change to nitrites inside the body and block oxygen in the blood. This lowers oxygen supply and makes baby’s skin turn bluish or greyish3,4.
Which drug causes blue baby syndrome?
Blue baby syndrome is rarely caused by drugs. The main medicine responsible is dapsone. Others that can sometimes lead to it include benzocaine, nitrate-containing solutions, and certain strong antibiotics. These medicines change the blood’s iron from working (ferrous) to non-working (ferric), reducing oxygen and making the baby appear blue12,13.
What blood type causes blue babies?
No specific blood type by itself causes a baby to turn blue. A baby may appear bluish if there is Rh incompatibility, when an Rh-negative mother carries an Rh-positive baby. This can lead to haemolytic disease of the newborn (HDN) and low oxygen, making the skin, lips, or nails look blue. However, this blood type-related Rh incompatibility does not lead to blue baby syndrome, which usually refers to babies who are blue due to heart problems or other oxygen-related conditions5.
Which element causes blue baby syndrome?
The main element linked is nitrogen from fertilisers or polluted water. In the body, nitrates turn into nitrites, which block haemoglobin. This cuts down oxygen supply, and slowly the baby shows blue or grey skin3,4.
Ykeda DS, Lorenzi-Filho G, Lopes AAB, Alves RSC. Sleep in Infants with Congenital Heart Disease. Clinics [Internet]. 2009 Dec 1 [cited 2021 Oct 2];64(12):1205–10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797590/
Keats KR, Robinson R, Patel M, Wallace A, Albrecht S. Ascorbic Acid for Methemoglobinemia Treatment: A Case Report and Literature Review. Journal of Pharmacy Practice [Internet]. 2023 Jul 8;8971900231188834. Available from: https://pubmed.ncbi.nlm.nih.gov/37421600/
Dias E, Mahendrappa KB, Arkasali MR. Drugs causing methemoglobinemia in children. Curr Overv Dis Health. 2023;7(7):52–7. Available from: https://hal.science/hal-05153269v1
Andrade SJ, Anusha Raj K, Lewis LE, Jayashree Purkayastha, Gaurav Aiyappa. Neonatal Acquired Methemoglobinemia – Can Broad Spectrum Antibiotics be Implicated? The Indian Journal of Pediatrics. 2019 May 20;86(7):663–3. Available from: https://link.springer.com/article/10.1007/s12098-019-02978-5
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Links and product recommendations in the informationprovided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.
Falls in the Elderly: Life expectancy, Causes, Prevention, & Safety Tips
Introduction
The World Health Organisation defines fall as “an event which results in a person coming to rest inadvertently on the ground or floor or other lower level.” About 684,000 falls are reported each year worldwide involving all ages1. However, accidental falls are more common in the elderly (over the age of 65 years). An estimated 30% of the elderly population have one or more falls each year, increasing up to 50% in adults over 80 years, worldwide2. By 2050, there are expected to be about 200 crore (2 billion) people over the age of 60 years worldwide.In India, the percentage of elderly people is estimated to be 12.4% of the entire population by the end of 20263. About 10 lakh (1 million) elderly people die in India annually, and almost twice as many are injured due to accidental falls. About 10% of the elderly experience recurrent falls4.This can lead to increased health care costs, especially out-of-pocket expenses. Accidental falls in the elderly are fast becoming a major health concern, leading to mental health issues in them and impacting their quality of life5. Fall prevention in the elderly and management of related injuries is a critical challenge for health care personnel globally.
Who is at Most Risk?
Although anyone can fall anytime, certain groups of people are at a higher risk of experiencing a fall, such as:
Increasing age, women, more than men of the same age
People with a previous episode of accidental falls
People with special socioeconomic factors like poor nutrition or individuals staying alone (single individuals)
People with certain medical conditions like:
Parkinson’s disease
Osteoporosis (women are more prone to osteoporosis)
Cataracts
Incontinence of urine
Joint pain, arthritis, osteoarthritis
Dementia
Orthostatic or postural hypotension
Numbness in the feet (peripheral neuropathy as seen in diabetes
Stroke
Diabetes
Cardiac arrythmias (heart rate disturbances) and other heart conditions
Dehydration
Orthostatic hypotension (a condition where there is a sudden fall in blood pressure when you change positions quickly, like sitting to standing)
Sarcopenia (muscle weakness)
Labyrinthitis and vestibular dysfunction (ear problems that can lead to poor balance)6,7,8
There is no one specific reason why the elderly fall. However, there are several factors which can increase the risk of falls and injury in the elderly. Some of these include:
1. Extrinsic or environmental factors
Uneven flooring, stairs, bunched up carpets, wet and slippery floors
Inadequate lighting, cramped spaces, clutter
2. Intrinsic or personalised factors
Improper footwear
Poor vision
Age-related balance or mobility issues
People with certain medical conditions that can cause impaired balance, unsteady gait (way of walking), cognitive impairment (forgetfulness, poor thinking and judgment and inability to make decisions), disabilities, joint and muscle problems, hearing disability, and vision problems
People taking certain medicines (mentioned in the section above)
3. Factors involving special circumstances
Rushing to the bathroom or to answer the phone or doorbell
Doing multiple things at a time causes distraction, for example, talking while walking
Most falls are the result of a combination of one or more factors.
Symptoms of Falls in the Elderly
Symptoms such as dizziness or light-headedness often precede some accidental falls. Many accidental falls may not cause major injuries. However, it is best to watch out for the following symptoms after a fall that may lead to serious complications:
Dizziness or light-headedness
Headache
Vision disturbances
Pain around the joints and the muscles
Difficulty in walking, moving, or getting up
Unconsciousness, strange behaviour
Bruises and bleeding cuts
Clear fluid or bleeding coming out of the nose or ears
Fits or seizures
Contact your doctor immediately if you have any serious symptoms after a fall10,11.
Diagnosis
There are no specific mandatory tests to be performed after a fall. However, doctors follow standard guidelines and may advise testing depending on the suspected cause of the fall, the type of injuries and your physical condition. These may include:
A thorough physical examination to evaluate the risk and assess the cause of the fall. Blood pressure measurement (to rule out orthostatic hypotension), vision and hearing assessment, and an electrocardiogram.
Doctors may perform one or more of the following tests to assess the balance and determine overall cognitive status in their clinics:
Comprehensive Geriatric Assessment (CGA), involving 5 domains of health, when combined, also assesses the risk of falls
Timed Up-and-Go Test for checking the gait
30-second Chair Stand test to check balance and strength
4-stage balance test for balance while standing in 4 different positions
Berg balance test involving 14 tasks with scores allocated to each task (the lower the score, the higher the risk)
Falls Efficacy Scale does not assess the risk of falls directly. It involves 16 activities with scores allocated to each activity on how concerned/fearful they are about falling (the higher the score, the greater the fear of falling)9,12.
Blood tests for measuring blood glucose levels, electrolytes, haemoglobin, vitamin D levels, etc, to determine the cause of the fall.
Imaging tests like X-rays, Ultrasound, CT scans, and/or MRIs to assess the damage, like broken bones, brain bleeds, etc., depending on your condition9,11.
Treatment of Falls in the Elderly
Treatment of falls in the elderly depends on the cause of the fall, the injuries caused by the fall and the physical condition. Broadly, they can be categorised as:
Treatment of injuries, like casting for fractures, physiotherapy for sprains, dressing and care for cuts and wounds. Only pain medication may be given for minor injuries, while surgical management may be needed for major ones. Treatment for some injuries requires a specialised setting (especially head and neck injuries, and fractures). For instance, in case of head injuries, neuroimaging and monitoring for intracranial bleeding are done, and neurosurgical care may be needed.
Treatment of the cause, like a change in medications, treatment of heart disease or muscle weakness, etc
Prevention of recurrence with exercises for improving balance and muscle strength
Every treatment should be tailored to each case, specifically involving multiple specialists like doctors, nurses, physiotherapists, social and community workers, etc. It is best to discuss the treatment options with your doctor13,14.
How to Prevent Falls in the Elderly?
Although it may not be realistically possible to prevent falls completely, steps may be taken to reduce the chances of falling and fall-related injury in elderly. Fall prevention in the elderly requires a multidimensional approach, for example:
Besides medical or clinical interventions, lifestyle changes and exercise programs should be incorporated in routine. Environmental or home modifications may be required to make the surroundings safer13,15.
Let’s have a look at these in detail in the next section.
Lifestyle and Environmental Changes
Making the elderly feel safe and building their confidence is of prime importance. Adopting certain lifestyle changes and following some safety guidelines can help reduce the risk of accidental falls, such as:
Installing grab bars wherever necessary, especially in the bathroom and toilets
Making things accessible easily, like light switches, telephones, cupboards, and cabinets
Maintaining good and adequate lighting, and installing night lights wherever possible
Removing clutter and making the furniture stable by removing wheels and rickety legs
Using non-slip mats under the carpets, in the bathtubs or showers, on the stairs, in areas where it can be wet and slippery
Keeping corridors and passageways clear of wires, cables, and cords
Removing crumpled or folded carpets, floor rugs and such from the floors and hallways
Replacing locks that can be opened from both sides to have access to a family member or medical team in case of an emergency.
Using a cane or a walker of optimal height for support
Using a personal alarm, emergency telephone or medical alert button, like a necklace or bracelet, with you always so that you can reach out for help in an emergency
Wearing comfortable footwear with anti-slip soles
Being mindful of your movements and surroundings. Get up or stand up slowly, taking enough time to adjust to the new position
Switching to comfortable, functional, and adaptive clothing. Sit down and dress. Keep your ankles clear of fabrics to avoid tripping over them
Resistance and/or strength training to improve balance and muscle strength
Endurance training, like treadmills, bicycles
Doing specific exercises focused on flexibility, functionality, and gait improvement, including Yoga and Tai Chi
Being regular with general checkups, eye exams, and hearing tests
Discussing with your doctor and being aware of the side effects of your medications, especially sleep medications like benzodiazepines (drowsiness), blood pressure medication (orthostatic hypotension), and medications used to treat mental health conditions like psychotropic medications Your doctor may prescribe safer combinations of medications or reduce the dosage of existing medications whenever possible to reduce your fall risk.
Carrying a list of emergency contacts with you if someone else needs to contact your loved ones or caregivers
Eating a balanced, nutritious diet and getting enough sleep
Avoiding smoking and alcohol
Supplementation with vitamin D and calcium (if advised), under medical supervision16, 17,18
Emergency Response and Follow-up
If you are attending to someone who has had a fall, call for an ambulance or emergency services if:
The person is unconscious
Is bleeding from cuts or through the ears or nose
Has problems with moving, speaking, or understanding instructions or advice
Many falls may cause only a slight injury or discomfort. However, if you do not recover from the mild symptoms within a couple of weeks, you should consult your doctor5,10. If you or someone around you is not feeling well or is uncomfortable after a fall, contact your doctor immediately. Seek medical help if you experience worsening of symptoms or developing new serious symptoms like:
Vomiting
Headaches
Dizziness, sleepiness, or drowsiness
Problems with vision, speech, orientation (like places and people), and balance
Seizures or fits
Clear fluid or blood from the nose or ears or worsening of bleeding
Weakness in thelimbs, unsteady walking or losing balance.
Falls in elderly are common and can be dangerous. A single fall can lead to a domino effect of health issues ranging from minor injuries to prolonged hospitalisations, immobility, and loss of independence. Fortunately, avoiding a fall or reducing the chances of a fall is frequently possible with the certain proactive measures. Fall prevention in the elderly is achievable by adopting a multidimensional approach of early recognition and reduction of the risk factors, regular health check-ups, and making optimal lifestyle changes. The responsibility of fall prevention is shared by health care professionals, family members, caregivers, the elderly themselves, and the wider community. Together, with a multidisciplinary, holistic approach, our elderly can not only avoid falls, but also enjoy a life of dignity, independence, and vitality that they deserve in their golden years.
Doctors can assess your risk of falling with the help of STEADI (Stopping Elderly Accidents, Deaths, and Injuries) protocol, which is developed by the Centres for Disease Control and Prevention in three stages: -Screening: A detailed history of previous falls, medical conditions, and problems with movement, like unsteadiness, imbalance, etc –Assessment: Your doctor can perform a series of tests to assess your fall risk. Ask your doctor if you want to know more about them. –Intervention: By helping you to make decisions on your health and implement strategies to reduce fall risk19.
What types of injuries are common with falls in the elderly?
Depending on the force of the fall and how you fall, different parts of the body may be involved, such as bones, joints, muscles, nerves, ligaments, tendons, and blood vessels. A fall can cause fractures of the bones or inside the joints, dislocations, sprains, muscle pulls, nerve damage, cuts, and bruises3,15.
How long does it take to recover from a fall?
The recovery process is slow in the elderly. The recovery time depends on the nature of the fall, injuries caused and the physical condition of an individual. Minor injuries may take a few days to heal. Major injuries like fractures, brain injuries, etc, may take a few months to more than a year. Ask your doctor about the recovery plan and how long it might take in your specific case20.
What is Tai Chi? How does it help reduce the risk of falls??
Tai Chi is a type of exercise routine used in China. It involves several `poses´ that use body weight and gravity to improve balance and strength. Movements like twisting of the torso, shifting of weight, squatting, and controlling the posture help with cognitive improvement. Tai Chi exercises may reduce the risk of falls by improving balance and strength21,22.
Which yoga exercises can help reduce my risk of falls?
Work under the supervision of a certified yoga teacher to learn `asanas´ or poses that improve balance and strength. Follow a simple yoga routine that is tailored to your fitness level and health conditions. To begin with, start with slow and simple exercises, gradually increasing in complexity to achieve the optimal benefits of yoga, and to reduce the risk of falls. Some such poses are: Tree pose Dancer pose Crescent warrior pose Warrior III pose Side plank Figure 4 pose Upward and downward facing dog poses23,24.
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Biswas I, Adebusoye B, Chattopadhyay K. Health Consequences of Falls among Older Adults in India: A Systematic Review and Meta-Analysis. Geriatrics [Internet]. 2023 Apr 18;8(2):43. [Cited 2025 Aug 15]. Available from: https://doi.org/10.3390/geriatrics8020043
Jindal HA, Duggal M, Jamir L, Sharma D, Kankaria A, Rohilla L, Avasthi A, Nehra R, Grover S. Mental health and environmental factors associated with falls in the elderly in North India: A naturalistic community study. Asian J Psychiatr. 2019 Jan;39:17-21. doi: 10.1016/j.ajp.2018.11.013. Epub 2018 Nov 15. PMID: 30472349 Available from: https://pubmed.ncbi.nlm.nih.gov/30472349/
Tillou A, Kelley-Quon L, Burruss S, Morley E, Cryer H, Cohen M, Min L. Long-term postinjury functional recovery: outcomes of geriatric consultation. JAMA Surg. 2014 Jan;149(1):83-9. doi: 10.1001/jamasurg.2013.4244. PMID: 24284836; PMCID: PMC3947094.[Cited 2025 Aug 20]. Available from: https://pubmed.ncbi.nlm.nih.gov/24284836/
Chen W, Li M, Li H, Lin Y, Feng Z. Tai Chi for fall prevention and balance improvement in older adults: a systematic review and meta-analysis of randomized controlled trials. Front Public Health. 2023 Sep 1;11:1236050. doi: 10.3389/fpubh.2023.1236050. PMID: 37736087; PMCID: PMC10509476. [Cited 2025 Aug 20]. Available from: https://pubmed.ncbi.nlm.nih.gov/37736087/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Prostate Cancer: Causes, Early Signs, Treatment Options & How to Lower Your Risk
Introduction
The prostate is a small gland in the male reproductive system, which is located below the bladder and in front of the rectum. It surrounds the urethra, the tube that carries urine and semen out of the body. The main function of the prostate is to produce a white, milky fluid called semen that helps carry sperm. The prostate muscles push out the semen during ejaculation through the urethra1.
So, what is prostate cancer? When the cells in the prostate start growing abnormally, it can turn into prostate cancer. In the early stage, these cells grow in a confined place within the prostate gland. But in advanced stages, the cancer spreads beyond the prostate to nearby tissues, adjacent lymph nodes, and to other parts of the body2.
Among men, prostate cancer ranks as the second most common type of cancer worldwide. The risk of developing prostate cancer is higher in men over the age of 50, and this risk continues to increase as men grow older3,4.
In this blog, we will explore the causes, early symptoms, available prostate cancer treatments, and ways to reduce the risk of developing prostate cancer.
Causes & Risk Factors
Prostate cancer develops due to various causes and risk factors. The reasons for prostate cancer include:
Family History: If there is someone in your family who got prostate cancer, there is a risk of you getting it because of a genetic or inherited factor that causes it. Especially if the relative who got cancer is young, the risk is higher.
Genetics: When certain inherited gene changes occur in the BRCA1 and BRCA2 genes (which cause breast or ovarian cancer) it could cause prostate cancer. Men with Hereditary Non-Polyposis Colorectal Cancer (HNPCC), also called Lynch syndrome (a genetic condition that increases the risk of several types of cancer), have a higher chance of getting prostate cancer due to these genetic alterations.
Age: As you age, the risk of getting prostate cancer increases. It is rare below 40 years, but after 50, the risk increases rapidly.
Race: The risk is higher in African Black men than in others, and they may also get more aggressive, advanced-stage cancer. The risk is less in Asian American and Hispanic men than in non-Hispanic white men5.
Diet: Another prostate cancer cause could be your diet. Those who eat a lot of red meat and processed meat have a high risk of getting prostate cancer.
Other factors like obesity and chronic inflammation of the prostate gland, may also contribute to an increased risk of prostate cancer5,6.
How to Recognise Early Signs & Symptoms
The signs of prostate cancer don’t usually show in the early stage, but if they do appear, they can be like
Weak urine flow, starting and stopping in between
Pain or burning while urinating
Sudden urge to urinate
Frequently urinating at night
In advanced stages, the prostate cancer symptoms may include:
Blood in semen
Blood in urine (rarely)
Bone pain
Pain in the hip
Loss of bladder or bowel control due to cancer growth pressing on the spinal cord
Weak or numb legs and feet
The urinary symptoms are seen when the prostate is enlarged and pressing on the urethra, which affects the flow of urine. But these symptoms can also be seen in conditions other than cancer. Therefore you need to visit a doctor, who will do certain tests and find out if you have prostate cancer5,7.
Diagnosis & Stages of Prostate Cancer
Since early-stage prostate cancer does not show symptoms, it is usually detected only through screening. When symptoms are seen in advanced prostate cancer stages, certain tests are done to diagnose prostate cancer, including:
Doctor taking history and doing physical exam: Your doctor will ask about your urinary symptoms, sexual problems, and bone pain.
Digital rectal exam: The doctor will do this examination by inserting a gloved finger into the rectum to feel if the prostate is hardened. Based on this, the doctor may ask you to take blood tests.
PSA blood test: The prostate produces prostate-specific antigen (PSA). The normal level should be less than 4. If it goes above the range of 4 to 10, then the chance of having prostate cancer is about 50%. This PSA test is done as a screening test for those without symptoms and also for those with symptoms it helps to confirm diagnosis.
Transrectal ultrasound: If your PSA levels are abnormal, this scan is done. A probe is inserted into your rectum and pictures of your prostate are viewed on a computer. This shows the size of the prostate and any changes.
Prostate biopsy: Based on symptoms and blood tests, if your doctor suspects you may have prostate cancer, he will ask you to get a biopsy done. A small area of tissue is taken from the prostate and examined under a microscope to check for cancer cells and to stage your cancer.
Other tests: If cancer is suspected to have spread to the bones, tests like bone scan, CT scan, or MRI scan may be needed in advanced stages, when the cancer has spread outside the prostate to lymph nodes or other parts of the body.
Based on these blood tests, scans, and biopsy reports, prostate cancer is classified into stages. There are 5 main things they look at to stage prostate cancer:
T category: This measures the size of the tumour and whether it has grown outside the prostate, based on exams, scans, and biopsy results.
N category: This shows whether the cancer has spread to nearby lymph nodes.
M category: This indicates whether the cancer has spread to other distant parts of the body.
PSA level: This assesses the risk of cancer spreading, with higher levels suggesting greater risk.
Grade Group (Gleason score): This is based on biopsy results and determines how quickly the cancer may grow or spread.
Based on these five factors, the table below shows the stage of prostate cancer, where the cancer is located, the TNM basics, and its category5,8.
Stage
Cancer characteristics
TNM basics
PSA level
Extent of cancer
Stage I
Cancer is only in the prostate. May be very small, may not be felt or seen on imaging.
T1 (tumour is small, only in prostate), N0 (no lymph node spread), M0 (no spread to other organs)
Low (less than 10)
Localised
Stage II
Cancer is only in the prostate, larger or faster-growing
T2 (tumour larger but still in the prostate), N0 (no lymph node spread), M0 (no spread to other organs)
Moderate (between 10 and 19)
Localised
Stage III
Cancer has grown through the outer layer of the prostate into nearby tissues (such as seminal vesicles) but has not spread to distant organs.
T3–T4 (tumour has grown outside prostate), N0 (no lymph node spread), M0 (no spread to other organs)
High (20 or more)
Locally Advanced
Stage IV
Cancer has spread to nearby lymph nodes and/or distant parts of the body such as bones, lungs, or liver.
Any T (any tumour size), N1 (spread to lymph nodes) and/or M1 (spread to distant organs)
High (20 or more)
Metastatic
Staging of prostate cancer is important because it shows how far the cancer has spread and how the patient is likely to recover over time. It also helps doctors choose the best treatment plan for managing the disease8.
Is Prostate Cancer Curable?
Prostate cancer can often be cured especially when detected early. The treatment for prostate cancer depends on which stage the cancer is in and the overall health of the person. The type of treatment given also plays an important role in how long a patient can survive after treatment.
The average five-year survival rate of prostate cancer, that is the percentage of patients who are likely to survive the effects of cancer until or after 5 years of diagnosis, is about 97%. This also depends on the stage upon diagnosis.Most prostate cancers (about 69%) are found when the cancer is still inside the prostate. At this stage, nearly everyone (100 out of 100) lives at least 5 years after diagnosis. If the cancer has spread to nearby areas, the chances are still very good (also 100 out of 100). But if the cancer has spread to other parts of the body, the chances go down, with about 38 out of 100 individuals living 5 years or more9,10.
Treatment Options Based on Stage
Based on the stage of prostate cancer, the treatment is planned by the doctor. For stages 1 to 3, the doctor classifies them into risk groups. Cancers in low-risk groups are less likely to grow or spread than those in high-risk groups. Other factors like age, general health, and life expectancy are also considered when choosing treatment.
1. Stage 1 and 2 (Localised)
The low-risk groups do not always need treatment, as the cancer is less likely to grow or spread. Doctors often suggest active surveillance, which means having regular check-ups and tests to keep an eye on the cancer.
In those groups where there is a slight chance that cancer can grow or spread faster, the prostate cancer treatment options include:
Surgery (radical prostatectomy, sometimes with removal of nearby lymph nodes)
Radiation therapy (external beam or brachytherapy)
Focal therapy: freezing the tumour (cryotherapy) or destroying it with focused ultrasound (HIFU); used only in special cases and not usually the first choice
If surgery shows aggressive features, follow-up radiation therapy may be advised and hormone therapy if needed.
2. Stage 3 (Locally advanced)
If prostate cancer is more aggressive and has a higher chance of growing and spreading quickly, treatment options often include:
Radiation therapy (external beam, sometimes with brachytherapy) given along with hormone therapy for 1–3 years.
Surgery (radical prostatectomy) with removal of nearby lymph nodes.
Hormone therapy to stop the body from producing testosterone. This can be medical (androgen deprivation therapy, LHRH agonists and anti-androgens) or surgical (orchiectomy- removal of testicles).
If surgery shows the cancer is aggressive, doctors might recommend follow-up radiation to the area where the prostate used to be, possibly with hormone therapy.
3. Stage 4 (Advanced stage)
If cancer spreads to nearby lymph nodes but not to distant organs, radiation is given along with hormone therapy, if needed. Surgery of the prostate and lymph nodes may also be an option.
If the cancer has spread to distant organs, treatment options include:
Chemotherapy with drugs like docetaxel (first line) or mitoxantrone along with steroids (prednisolone)
Drugs like bisphosphonates if cancer spreads to bones
For very high-risk cancers, doctors may add newer hormone drugs like abiraterone.
Other treatments to help manage symptoms like bone pain include external radiation, sometimes in a precise form called stereotactic body radiation therapy (SBRT). Bone-strengthening medicine like denosumab or zoledronic acid may help, and radioactive drugs such as radium-223, strontium-89, or samarium-153 can also be used.
If the cancer comes back or keeps growing, treatments like immunotherapy, targeted drugs, chemotherapy, or more hormone therapy may be given as the doctor advises5,11.
There are some side effects from prostate cancer treatment, based on the type of treatment used that can include the following:
Surgery: It may cause urine leaks, trouble getting or keeping an erection, bleeding from the bottom, blood clots, lung problems, and infections.
Radiation: Some may experience trouble with erections, pain or irritation near the bottom, diarrhoea, and bladder problems like burning, blood in pee, or leaks.
Hormone Therapy: It can lower male hormones and cause weak erections, less interest in sex, muscle loss, weight gain, weak bones, hot flashes, sweating, and breast swelling. Sometimes, it can also affect blood sugar and fats5.
If you have side effects from prostate cancer treatment, talk to your doctor who will guide you on how to manage them.
How to Avoid or Lower Your Risk?
You can lower the risks of getting prostate cancer by making a few lifestyle changes which include:
Maintain healthy weight and stay active: There is a high risk of getting advanced prostate cancer for men with increased body weight. Therefore, maintaining a healthy weight is important. It’s good to indulge in physical activity regularly.
Eat healthy diet: Eating a lot of colourful fruits and vegetables can provide vitamins and antioxidants that protect your cells. Whole grains are much better than processed food. Try to limit eating red meats like beef or processed meats like sausages and bacon, as these can increase the risk of cancer. Don’t consume excessive sugary drinks and junk food as it can lead to weight gain and increase the risk.
Limit calcium intake: Too much calcium from supplements or diet may increase prostate cancer risk. For those with high risk, it is better to avoid high doses unless your doctor has advised it12.
Quit smoking: Cigarette smoke contains many harmful chemicals which can cause different types of cancer including prostate cancer. Therefore, it is advised to stop smoking to lower the risk13.
Get regular screening: Men above age 50 or those with family history of prostate cancer should get regular screening. PSA test is commonly used for screening. High PSA levels don’t always mean cancer, but your doctor will do further evaluation to confirm7,14.
Supplements: Folic acid-rich food such as green vegetables, beans and orange juice may lower risk of prostate cancer, but high-dose folic acid supplement may not help. Lycopene and soy protein may show benefit to reduce risk, although further studies are needed12,15.
Apart from these lifestyle changes, some medicines like finasteride and dutasteride may help lower prostate cancer risk by blocking hormones that make the prostate grow. But you must only take these if advised by your doctor12.
When to See a Doctor
Any man aged about 50 years or above needs to talk to a doctor about getting a prostate cancer screening test to check prostate health. You need to see a doctor if you have any of these prostate cancer symptoms, including14,16:
Need to urinate often at night
Weak urine flow
Difficulty starting to urinate
Sudden strong urge to urinate
Trouble emptying the bladder fully
Pain or burning while urinating
Blood in urine or semen
Pain in the lower back or hips
Unexplained weight loss
Conclusion
Prostate cancer is common in men over fifty but catching it early with regular screenings makes it easier to treat and manage well. You can also lower your risk by living healthy, staying active, eating right, quitting smoking, and getting regular prostate check-ups. Knowing the early signs and getting prompt medical attention can make a huge difference in its preventing spread and enhancing treatment outcome.
Frequently Asked Questions (FAQs)
Can prostate cancer be cured if caught early?
If prostate cancer is found early, it can be treated very well. Most men (about 7 out of 10) are diagnosed when the cancer is still inside the prostate. At this stage, almost everyone lives for 5 years or more after diagnosis10.
Does prostate cancer always require surgery?
Not always. If the cancer is slow-growing or you’re older with no symptoms, doctors may just watch it closely. Surgery is usually done only if the cancer grows or spreads outside the prostate7.
Can young men get prostate cancer?
Yes, young men between 25 and 40 can get prostate cancer, but it is rare. Cases are rising because doctors are finding them more frequently through screening tests. Younger men often have more advanced cancer when diagnosed17.
How fast does prostate cancer spread?
Prostate cancer often grows slowly and stays inside the prostate for many years. Some mild types stay local and don’t spread. About 69% of cases stay local, 14% spread nearby, and 8% spread to distant parts. The types that spread fast can do so within 3 to 5 years10,18.
Huncharek M, Haddock KS, Reid R, Kupelnick B. Smoking as a Risk Factor for Prostate Cancer: A Meta-Analysis of 24 Prospective Cohort Studies. American Journal of Public Health. 2010 Apr;100(4):693–701. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2836346/
Bleyer A, Spreafico F, Barr R. Prostate cancer in young men: An emerging young adult and older adolescent challenge. Cancer [Internet]. 2019;10.1002/cncr.32498. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31553489
Van EL, McKinley MA, Washington SL, Cooperberg MR, Kenfield SA, Cheng I, et al. Trends in Prostate Cancer Incidence and Mortality Rates. JAMA Network Open [Internet]. 2025 Jan 27;8(1):e2456825–5. Available from: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829547
Moreira DM, Howard LE, Sourbeer KN, Amarasekara HS, Chow LC, Cockrell DC, et al. Predictors of Time to Metastasis in Castration-resistant Prostate Cancer. Urology [Internet]. 2016 Jun 22 [cited 2025 Jun 14];96:171–6. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5536963/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Cervical Cancer: What is it, Symptoms, Causes & Treatment
Introduction
Cervical cancer remains a major public health challenge, ranking as the fourth most common cancer among women worldwide1. In India, it is the second most common cancer in women. By 2025, the burden of this cancer in India projected to reach 1.5 million Disability-Adjusted Life Years (DALYs), a measure that combines years of life lost due to premature death and years lived with illness or disability2.
This highlights the urgent need for action. Therefore, understanding what is cervical cancer, along with adopting preventive measures, ensuring early detection, and providing effective treatment, is essential for reducing its impact on women’s health.
Understanding the Cervix
The cervix is the narrow, lower portion of the uterus (womb) that connects it to the vagina (birth canal). It allows fluids (like menstrual blood and mucus) to flow from the uterus into the vagina, and it also widens during childbirth to allow the baby to pass through3.
Ectocervix: The outer part that can be seen during a pelvic exam.
Endocervix: The inner part that forms a canal linking the vagina to the uterus.
The junction/zone where these two parts of the cervix meet is called the squamocolumnar junction (or transformation zone). This is where the thin, flat squamous cells are found, and where most abnormal cell changes and cervical cancers originate.
What is Cervical Cancer?
Cervical cancer starts in the cells of the cervix. It usually develops slowly over time. Before cancer forms, the cells in the cervix may undergo changes (dysplasia) and abnormal cells appear in the cervical tissue3.
If these abnormal cells are not detected and treated, these abnormal changes may turn into cancer and grow deeper into the cervix or spread to nearby areas3.
HPV and Cervical Cancer
Human papillomavirus (HPV) is the primary cause of cervical cancer. It is a common sexually transmitted infection that can affect the skin, genital area, and throat. Certain high-risk types of HPV strains (such as HPV 16 and HPV 18) are responsible for about 70% of all cervical cancer cases worldwide4,5.
These viruses can infect the cells of the cervix and cause changes in their DNA. Over time, if the infection does not clear on its own or is left undetected, these changes can lead to dysplasia, which may eventually turn into cancer4.
However, it is important to note that HPV infections are extremely common, often transient, and only persistent infections with high-risk subtypes can lead to cancers. Presence of cofactors like smoking and poor immunity increase the progression risk.
In the early cervical cancer stages, cancer often develops without any noticeable symptoms. This makes it difficult to detect early. Symptoms typically appear only after the cancer has started to spread. Possible early-stage cervical cancer symptoms may include6:
Pelvic pain (especially in the lower abdomen)
Pain during sexual intercourse
Bleeding (vaginal) between periods or unusually heavy/extended periods
Bleeding (vaginal) after sexual intercourse or menopause
Watery vaginal discharge (accompanied by a strong odour or blood)
Postcoital bleeding (bleeding after intercourse) is sometimes the first and the only sign
When cervical cancer becomes advanced (spreading beyond the cervix), symptoms can include those listed above, along with6:
Constant fatigue
Persistent dull backache or abdominal pain
Swelling in the legs
Painful or difficult bowel movements, or rectal bleeding during bowel movements
Painful or difficult urination
Blood in the urine
Foul smelling discharge
Note: It is important to remember that these symptoms can be caused by conditions other than cervical cancer. However, the only way to know for sure is to consult a doctor.
Cervical Cancer Causes
As discussed earlier, the main cause of cervical cancer is persistent infection with high-risk types of HPV1.
Almost all sexually active individuals may get HPV at some point (often without symptoms), and in most cases, the immune system clears the virus naturally. However, if the infection with a high-risk HPV type does not go away or is left unaddressed (for around 10 to 15 years), it can cause abnormal cell changes in the cervix that may eventually develop into cervical cancer1.
Cervical Cancer Risk Factors
Risk factors that increase the chance of developing cervical cancer include4:
Infection with high-risk HPV types (e.g., HPV 16 and 18)
Smoking
Early age of first sexual intercourse
Multiple sexual partners
High number of births or high parity (due to increased risk of HPV exposure or hormonal/immune influences)
Long-term use of hormonal contraceptives
Weakened immune system (e.g., HIV infection)
Co-infection with other sexually transmitted infections (e.g., Chlamydia trachomatis or herpes simplex virus)
Types of Cervical Cancer
Cervical cancers are classified based on the type of cell where the cancer begins. The main types include:
Squamous Cell Carcinoma: The most common type, accounting for up to 90% of cervical cancer cases. It develops from the squamous cells found in the ectocervix3.
Adenocarcinoma: This type develops in the glandular cells of the endocervix3.
Clear cell carcinoma or mesonephroma: A rare subtype of cervical adenocarcinoma, characterised by abundant clear, glycogen-rich cytoplasm and distinct cell membranes3,7.
Mixed Carcinoma (Adenosquamous Carcinoma): This type contains features of both squamous cell carcinoma and adenocarcinoma and although rare, it is usually more aggressive3.
Note: Very rarely, cervical cancer can even start in other cell types within the cervix3.
Cervical Cancer Stages
Cervical cancer staging describes how far the cancer has grown or spread. Stages include8:
Stage I: Cancer is confined only to the cervix.
Stage II: Cancer has spread beyond the cervix to the upper two-thirds of the vagina or surrounding tissue, but not to the pelvic wall.
Stage III: Cancer involves the lower third of the vagina, pelvic wall, causes kidney issues, and/or has spread to lymph nodes.
Stage IV: Cancer has spread beyond the pelvis or to nearby organs like the bladder or rectum, or distant organs.
Note: The staging now incorporates imaging and pathology findings also.
Diagnosis of Cervical Cancer
If symptoms suggest cervical cancer, further tests are done to confirm the diagnosis. The process often starts with a colposcopy, where the cervix is examined using a magnifying device after applying acetic acid and Lugol’s iodine solution to highlight abnormal areas. If suspicious areas are seen, a biopsy is performed to collect tissue for examination under a microscope. These tests are a crucial part of visual screening in resource-limited areas.
Punch biopsy: Removes small tissue samples from the cervix.
Endocervical curettage: Scrapes cells from the cervical canal.
Loop electrosurgical excision procedure (LEEP): Utilises a thin wire (with an electrical current) to remove tissue. It can also treat early changes.
Cone biopsy (conisation): Surgically removes a cone-shaped section of tissue from the cervix, often under general anaesthesia.
If cervical cancer is confirmed, you will be referred to a gynaecologic oncologist (a specialist in staging and treating cancers of the female reproductive system). They will order tests to determine the stage of the cancer, whether it is confined to the cervix or has spread to other parts of the body.
Note: Excisional biopsy (biopsy where the entire suspicious tissue is removed) can be both diagnostic or therapeutic in very early stages.
Imaging tests: PET-CT scan, MRI, ultrasound, or chest X-ray to locate tumours and detect spread.
Lab tests: Complete blood count and blood chemistry studies to assess overall health and organ function.
Visual examinations: Cystoscopy (to check the bladder) and sigmoidoscopy (to check the rectum and lower colon).
Cervical Cancer Treatment
Cervical cancer treatment depends on the stage of the disease, overall health, and personal preferences. Most patients receive a combination of therapies to remove or destroy cancer cells and prevent recurrence. Common treatments include10:
Radiation therapy: Kills cancer cells using high-energy rays. It can be external (known as external beam radiation) or internal (known as brachytherapy).
Chemotherapy: Kills or stops cancer cells from dividing. It is often combined with radiation in advanced cervical cancer stages. Some common drugs include:
Sentinel Lymph Node Biopsy: Removal of the first lymph node(s) that cancer is most likely to spread to, to check for cancer cells.
Conisation (Cone Biopsy): Surgical removal of a cone-shaped section of the cervix containing abnormal or cancerous tissue.
Radical Trachelectomy (Fertility-Sparing): Removes the cervix and surrounding tissues but preserves the uterus to allow future pregnancy. This along with pelvic lymph node assessment is a valid option for selected early-stage cases.
Bilateral Salpingo-Oophorectomy: Removal of both fallopian tubes and ovaries.
Hysterectomy: Surgical removal of the uterus.
Total Hysterectomy: Removes the uterus and cervix.
Radical Hysterectomy: Removes the uterus, cervix, upper vagina, and a wide area of surrounding tissues, often including pelvic lymph nodes.
Modified Radical Hysterectomy: Removes the uterus, cervix, part of the vagina, and surrounding tissues, but less extensively than a radical hysterectomy.
Total Pelvic Exenteration: Removal of the uterus, cervix, vagina, bladder, rectum, and part of the colon in advanced cancer cases.
Note: A treatment plan is tailored to each patient and may also consider fertility preservation, pregnancy, and follow-up care. It is therefore essential to discuss all available options with your doctor.
Side Effects of Cancer Treatment
Cervical cancer treatment (such as radiation therapy, chemotherapy, targeted therapy, or surgery) can cause a range of side effects. These may vary depending on the type, stage of cancer, and individual response to treatment.
Skin changes (especially in areas exposed to radiation)
Hair loss (mainly with certain chemotherapy drugs)
Vaginal dryness or narrowing
Decrease in sexual drive
Other than these, with radiation treatment, premature ovarian failure and early menopause may occur in premenopausal women. Also, after radical hysterectomy, possible bladder dysfunction can happen due to autonomic nerve damage.
Complications of Cervical Cancer
In advanced stages, cervical cancer and its treatments may lead to several serious complications, similar to those seen in other cancers. These may include4:
Chronic pain
Hydronephrosis (swelling of the kidneys)
Lymphedema (swelling in the legs)
Fistulas (abnormal openings between organs)
Bleeding disorders
Renal failure
Infertility
Besides the above-mentioned, there are concerns which impact quality-of-life such as sexual dysfunction, psychological effect and body image issues and unfortunately these are often under-addressed.
Can Cervical Cancer be Cured Completely?
Cervical cancer can often be cured if it is detected and treated in its early stages1.
Recognising cervical cancer causes and obtaining an early diagnosis through regular screening, such as Pap smears and HPV testing, could greatly improve the chances of cure4. Additionally, when caught early, treatments like surgery, radiation therapy, or a combination of radiation and chemotherapy can be highly effective. However, the likelihood of a cure may decrease if the cancer is diagnosed at an advanced stage, as it may have spread to other parts of the body.
Therefore, regular screening, HPV vaccination, and prompt treatment of precancerous changes are advised for improving long-term survival rates.
Living With Cervical Cancer
Living with cervical cancer can be physically and emotionally challenging, but with the right support, care, and mindset, many women are able to maintain a good quality of life during and after treatment. Coping strategies may include:
Eating small, frequent, nutrient-rich meals and drinking plenty of fluids.
Getting adequate rest while staying moderately active to fight fatigue.
Joining support groups, talking to a counsellor, or leaning on friends and family.
Discussing any intimacy-related concerns with your doctor for advice and solutions.
Attending all scheduled follow-up tests and appointments for monitoring and managing side effects10.
Always keep in mind that managing side effects is an important part of treatment, and your doctor can provide medications, therapies, and lifestyle guidance to help you cope effectively.
Prevention tips focus on reducing cervical cancer risk factors, protecting against HPV infection, and ensuring early detection through regular screening. Some proactive steps include:
Get vaccinated against HPV: The HPV vaccine protects against high-risk HPV strains (especially HPV 16 and 18). It is most effective when given before becoming sexually active (9-14 years) but can be given up to 26 years.In India, the bivalent (Cervarix), quadrivalent (Gardasil), and nonavalent (Gardasil 9) vaccines are available13.
Attend regular screening tests: Pap smears and HPV tests help detect abnormal cervical changes early, when they could be treated before turning into cancer. According to latest WHO recommendations13, HPV DNA testing should be done every 5–10 years for women aged 30–49, or Pap smear every 3 years where HPV testing isn’t available14.
Practice safe sex: Using condoms and limiting the number of sexual partners can reduce the risk of HPV transmission13.
Avoid smoking: Smoking weakens the immune system and increases the risk of cervical and other cancers1.
When to See a Doctor
You should seek medical attention promptly if you notice any signs or symptoms that could indicate cervical cancer. These may include6:
Unusual vaginal bleeding (between periods, after sex, or after menopause)
Persistent pelvic pain or discomfort
Unexplained vaginal discharge, especially if foul-smelling or blood-stained
Pain during sexual intercourse
Changes in menstrual patterns that are unusual for you
Note: Even if your symptoms seem mild, early evaluation can help detect problems sooner and improve treatment outcomes. Additionally, regular gynaecological check-ups and screenings are equally important, even if you have no cervical cancer symptoms.
Cervical cancer can often be prevented and is highly treatable if found early.
Regular screening, HPV vaccination, and adopting healthy lifestyle habits can greatly reduce the risk of developing the disease. Additionally, early detection enables timely treatment, which improves the chances of a complete cure and helps maintain a good quality of life. Therefore, by staying aware of cervical cancer symptoms, attending routine checkups, and following cervical cancer prevention measures, individuals can take proactive steps to protect themselves.
Frequently Asked Questions (FAQs)
Can men get cervical cancer?
Cervical cancer occurs only in individuals with a cervix. However, men can carry and transmit the human papillomavirus (HPV), which is the primary cause of cervical cancer. Moreover, in men high risk HPV can cause cancers such as penile, anal or oropharyngeal cancer. This is why HPV vaccination is recommended for both males and females1,4.
Can cervical cancer go unnoticed until it reaches the later stages?
Cervical cancer in its initial stages may not always cause any noticeable symptoms. That is why regular Pap smears or HPV testing are essential for early detection4,6.
Can diet or lifestyle changes cure cervical cancer?
While a healthy lifestyle can boost overall immunity and reduce cancer risk, it cannot cure cervical cancer15. Medical treatment is necessary for managing the disease.
Does obesity increase the risk of cervical cancer?
Obesity does not directly cause cervical cancer, but it can make screening more challenging4,16.Excess body weight may make pelvic examinations and Pap smears technically harder, which may lead to missed or delayed detection of precancerous changes. This delay could therefore increase the risk of cervical cancer being diagnosed at a later stage16.
Ramamoorthy T, Kulothungan V, Sathishkumar K, et al. Burden of cervical cancer in India: estimates of years of life lost, years lived with disability and disability adjusted life years at national and subnational levels using the National Cancer Registry Programme data. Reprod Health. 2024;21:111. Available from: https://rdcu.be/ezV6c
Fowler JR, Maani EV, Dunton CJ, et al. Cervical Cancer. StatPearls [Internet]. StatPearls Publishing; [cited 2025 Aug 09]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431093/
Ahmed HG, Bensumaidea SH, Alshammari FD, Alenazi FSH, ALmutlaq BA, Alturkstani MZ, Aladani IA. Prevalence of Human Papillomavirus subtypes 16 and 18 among Yemeni Patients with Cervical Cancer. Asian Pac J Cancer Prev. 2017 Jun 25;18(6):1543-1548. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6373819/
Cue L, Martingano DJ, Mahdy H. Clear cell carcinoma of the cervix. StatPearls [Internet]. StatPearls; [Publishing cited 2025 Aug 09]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546591/
Palagudi M, Para S, Golla N, Meduri KC, Duvvuri SP, Vityala Y, Sajja DC, Damineni U. Adverse Effects of Cancer Treatment in Patients With Cervical Cancer. Cureus. 2024 Feb 13;16(2):e54106. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10938271/
Hajiesmaeil M, Mirzaei Dahka S, Khorrami R, Rastgoo S, Bourbour F, Davoodi SH, Shafiee F, Gholamalizadeh M, Torki SA, Akbari ME, Doaei S. Intake of food groups and cervical cancer in women at risk for cervical cancer: A nested case-control study. Caspian J Intern Med. 2022 Summer;13(3):599-606. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9348217/
Maruthur NM, Bolen SD, Brancati FL, Clark JM. The association of obesity and cervical cancer screening: a systematic review and meta-analysis. Obesity (Silver Spring). 2009 Feb;17(2):375-81. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3008358/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Did you know that leukaemia (a type of blood cancer) is the most common cancer diagnosed in children? It accounts for approximately 30.8% of all cancer cases in this age group1.
Blood cancer, also referred to as haematological cancer is defined as cancer originating in the blood-forming tissues such as the bone marrow, lymph nodes and other parts of the lymphatic system1,2. Common types of blood cancer include leukaemia (cancer of the blood cells and bone marrow, characterised by uncontrolled proliferation of abnormal or immature white blood cells), lymphoma (cancer of the lymphatic system), myeloma (cancer of plasma cells in the bone marrow), and rare types of blood cancers such as myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPNs)3,4.
Early recognition of symptoms and diagnosis can help to improve your treatment outcomes and increase your chances of long-term survival5.
What Are the Types of Blood Cancer?
Blood cancers can be classified into different types depending on the cells of the blood, bone marrow or lymphatic system affected. The blood cancer types include:
1. Leukaemia
Leukaemia is a cancer that affects your blood cells. It begins in the bone marrow and affects the white blood cells, red blood cells, and platelets. In this condition, your bone marrow produces a large number of abnormal cells, especially white blood cells. Leukaemia can be classified into four types – acute lymphocytic leukaemia (ALL), acute myeloid leukaemia (AML), chronic lymphocytic leukaemia (CLL), and chronic myeloid leukaemia (CML). Broadly, based on how quickly it develops, leukaemias can be classified into two types6:
Acute leukaemia: This type of leukaemia develops and progresses rapidly. Hence, prompt treatment is needed.
Chronic leukaemia: This type of leukaemia progresses slowly and the individual’s condition worsens over a longer period of time, if not treated.
Based on the type of cells affected, leukaemia blood cancer types include6:
Myeloid leukaemia: The myeloid cells (immature cells that develop into granulocytes, monocytes, red blood cells or platelets) are affected.
Lymphoid leukaemia: Lymphocytes, a type of white blood cell, are affected.
2. Lymphoma
Lymphomas are cancers of the immune system that account for approximately 5% of all cancers. Lymphomas occur due to the abnormal growth and multiplication of lymphocytes at different stages of their maturation. Lymphomas can be classified as Hodgkin’s and non-Hodgkin’s lymphomas7.
Hodgkin’s Lymphoma: Defined by the presence of abnormal cells known as Reed Sternberg cells. In most cases, no causative agent has been detected, however, studies have shown many a link between Epstein Barr Virus and Hodgkin’s lymphoma (especially mixed cellularity subset and in immunosuppressed individuals).
Non Hodgkin’s Lymphoma: This is a heterogeneous group with several subtypes where there are no Reed Sternberg cells present. Each of these subtypes differ greatly in prognosis and treatment.
3. Multiple Myeloma
Multiple myeloma is a cancer that causes the abnormal proliferation of plasma cells in your bone marrow. These plasma cells are responsible for forming some of the proteins found in your blood. If not treated, the cancer can damage organs such as bones, kidneys, blood (anaemia), and immune system in your body. This can be summarised by CRAB criteria (high calcium levels [hypercalcaemia], renal [kidney] problems, anaemia [low red blood cell count], and bone pain)8.
Rare Types of Blood Cancer
These include:
Myelodysplastic syndrome (MDS): This is a condition where the bone marrow doesn’t produce enough healthy blood cells. Often seen in older adults (above 65 years of age), this condition can cause symptoms like fatigue, frequent infections, and easy bruising or bleeding. In some cases, MDS can progress to AML9.
Myeloproliferative neoplasms (MPNs): Stem cells in the bone marrow can potentially develop into many types of blood cells. Sometimes, the body overproduces certain cells, causing disorders like MPNs. The four classical types of MPNs include essential thrombocythemia, CML, primary myelofibrosis, and polycythemia vera (PV)10.
A lump or swelling in the lymph tissues due to the abnormal proliferation of lymphocytes, causing swollen lymph nodes. This can be commonly noticed in your armpit, neck, or groin region.
Profuse night sweats that can soak clothes and sheets.
Infections that are persistent, severe and recur frequently.
Fatigue or tiredness that does not improve after sleeping or resting.
Persistent or recurrent fever. Some blood cancers, such as lymphomas, may present with low-grade fevers or intermittent fever referred to as B symptoms7.
Itchiness is more common in Hodgkin’s lymphoma and certain leukaemias. While rashes may appear in leukaemias, they are not a universal sign12.
Pain in the bones, abdomen or joints.
If you are facing any of these signs and symptoms, it is recommended that you speak to your doctor and seek prompt medical care.
What Causes Blood Cancer?
Blood cancer is believed to be caused due to damage to the DNA of a single haematopoietic stem (blood-forming cell) or progenitor cell. While this is sometimes triggered by one key event, it may also develop gradually through several genetic changes over time. These abnormal cells multiply and eventually collect in the bone marrow, blood, or lymphatic system. This process interferes with the normal production and functioning of the normal healthy cells leading to anaemia, increased bleeding risk due to thrombocytopenia (low platelets) and an inability to fight infections1.
Although the exact causes of blood cancer remain unclear, many genetic and environmental risk factors are identified, which include13,14:
Previous exposure to cancer treatments (chemotherapy)
Exposure to intense radiation
Exposure to certain chemicals, such as benzene
Family history of leukaemia
Exposure to certain viral infections, for example, Epstein Barr virus is linked to some lymphomas, while human T-cell leukaemia virus type 1 (HTLV-1) is associated with adult T-cell leukaemia and certain subtypes of ALL7,13,14.
Age and gender
Syndromes that have a genetic origin, such as Down syndrome and Fanconi syndrome.
Understanding these risks is essential for the early detection of blood cancers.
Is Blood Cancer Curable?
Although most blood cancers are not curable, some can be cured based on the stage and type of blood cancer15.
Acute lymphoblastic leukaemia: Children with ALL show high cure rates, though certain individuals may present with a high risk of relapse16.
Chronic myeloid leukaemia: Treatment of CML with tyrosine kinase inhibitors (TKIs) may help to keep the condition under control for many years and is associated with a high survival rate. Advances with modern TKIs have made it possible for some patients to reach a deep level of remission, making it possible to stop treatment while still staying in long-term remission without medication17.
Non-Hodgkin’s lymphoma: Aggressive forms of Non-Hodgkin’s lymphoma can be cured in more than 50% of cases with intensive chemotherapy. Diffuse large B-cell lymphoma often responds well to R-CHOP (chemotherapy regimen), but cure rates depend on the type and the patient’s overall health. Although slower-growing forms of the lymphoma respond well to treatment, (especially in the early stages), advanced stages may relapse despite good long-term survival. Studies18 have shown that modern therapy has improved 5-year survival rates to over 60%.
Multiple myeloma: Although multiple myeloma is considered an incurable disease, treatment with high-dose therapy followed by autologous stem cell support ensures that 3-10% of individuals with multiple myeloma remain free of active disease for more than 10 years after treatment19.
Your treatment outcomes can vary depending on the stage of the disease, your age, your health conditions, and the response of cancer to treatment.
Blood Cancer Stages and Classification
Staging is incorporated to help in the classification based on how much cancer is present in your body. The blood cancer stages include20:
Leukaemias: Leukaemias usually do not use a defined staging method and most leukaemias are classified based on the disease subtype, severity and its effect on your body. However, ALL and AML use risk stratification systems (grouping patients by their risk level). CML uses a staging system (Rai, Binet, and CLL-IPI systems). These systems provide the staging based on lymph node involvement, organ enlargement, anaemia, and platelet levels20.
Lymphomas: Both Hodgkin and most Non-Hodgkin lymphomas use the Ann Arbor staging system. It describes how far the cancer has spread ranging from stage I (single node region) to stage IV (widespread organ involvement), with A indicating the absence or B indicating presence of symptoms like persistent fevers, unexplained weight loss, and night sweats21,22.
Multiple myeloma: Uses the International Staging System (ISS), and the Revised ISS (R-ISS), which relies on blood levels of β2-microglobulin, albumin, serum lactate dehydrogenase and high-risk cytogenetics23.
Understanding staging and grading of blood cancers helps in the treatment planning and determining your prognosis.
How Is Blood Cancer Diagnosed?
After a careful assessment of your symptoms, family history, and a physical examination, your doctor may suggest certain tests which will help in making an accurate diagnosis24:
Blood Tests: These include:
Complete blood count: This test helps to count the number of red blood cells, white blood cells and platelets in your blood.
Blood differential test: This test helps to check the amount of each type of white blood cell (lymphocytes, neutrophils, monocytes, eosinophils, and basophils) present in your blood25.
Biopsy: This is a definitive method of diagnosing blood cancer. Your doctor may suggest bone marrow biopsy or lymph node biopsy to accurately diagnose the type of cancer you have:
Lymph node biopsy: If you present with swollen lymph nodes, your doctor may remove a part of the affected lymph tissue for examination. This method can be used to diagnose certain lymphomas without marrow involvement26.
Bone marrow biopsy: Involves the removal of a sample of bone marrow to check for blood cancer. Can be used to diagnose many leukaemias and myelomas14.
Peripheral blood flow cytometry: This test can help diagnose certain leukaemias, such as CLL, if many cancer cells are present in the blood.
Tumour marker tests: These tests help to check and measure the substances that are produced by the body in response to cancer, for example, LDH can be used for lymphoma prognosis. These tests have a limited role in blood cancers7.
Imaging Tests: These tests are mainly done to assess the extent of your disease. They include:
Nuclear scan: Uses a small amount of radioactive material or tracer to indicate how organs or tissues are functioning.
PET-CT scan: Preferred imaging tool for lymphomas. It helps in the initial staging, assessing treatment response, and detecting potential recurrence27.
Ultrasound: Uses high-frequency sound waves to create real-time images of organs and tissues without radiation.
X-rays: Uses low-dose radiation to capture quick, simple images of bones and certain body structures.
MRI: Rarely used. Uses a strong magnet and radio waves to produce detailed cross-sectional images that are sometimes enhanced with a contrast agent, for example, in cases of central nervous system involvement or spinal cord compression.
Bone scan: Rarely used. This is a nuclear scan that detects any abnormal bone changes.
Immunophenotyping: Mainly done on blood or bone marrow samples, this test uses antibodies to identify cells based on the antigens or markers that are present on its surface. This test can be used for the identification and staging of leukaemias, lymphomas, myelodysplastic syndromes, and myeloproliferative disorders.
Cytogenetic Analysis (Karyotyping, FISH): Helps to detect chromosomal abnormalities, such as translocations and deletions, that are crucial for diagnosis. It also guides risk stratification (understanding a person’s risk level) and influences treatment decisions, such as eligibility for targeted therapies28.
Molecular Testing (e.g., PCR for BCR-ABL and JAK2): Identifies specific gene mutations that confirm the diagnosis and enable targeted therapy selection29.
There are many subtypes of blood cancers, each requiring different treatment. The correct identification can directly impact your prognosis, treatment choice, and expected outcomes.
Blood cancer treatment depends on the type of blood cancer, its extent, and other factors such as the individual’s age and overall health. Treatment options typically include chemotherapy (medicine given through a vein to kill the cancer cells or slow their growth), radiation therapy (uses radiation to damage cancer cells to prevent their multiplication), targeted therapies (medications that are designed to act more specifically on cancer cells, though some may also affect healthy cells), immunotherapy (medications that boost your immunity so that your body can fight the cancer), and stem cell or bone marrow transplantation (involves placement of healthy stem cells after chemotherapy)14.
Leukemias (ALL, AML, CLL, CML) are often managed with combinations of chemotherapy, targeted therapies, and sometimes bone marrow transplantation14.
Lymphomas frequently use chemotherapy combined with immunotherapy7.
Multiple myeloma is treated with targeted drugs, immunomodulators, and, in eligible patients, transplant8.
Newer blood cancer treatments include CAR-T cell therapy (indicated for cancers such as ALL, non-Hodgkin lymphomas, advanced B cell malignancies and relapsed or refractory leukaemias), antibody–drug conjugates (such as Gemtuzumab ozogamicin for AML), and menin inhibitors (mainly used for AML subtypes with specific genetic abnormalities), offering better treatment results for patients with resistant or relapsed disease30,31.
Can Cancer Spread From One Person to Another Through Blood?
Blood cancer cannot be transmitted from one person to another. In other words, blood cancers are not contagious. They cannot spread by sharing needles, meals, or close contact. Even if cancer cells enter your body, your immune system recognises these cells and destroys them as you have a healthy immune system, although in rare cases, they can evade detection. Transmission of cancer is also unlikely because cancer cells are fragile and do not survive well outside the body32,33. While blood contact and sharing needles can lead to an increased risk of infectious diseases such as HIV and hepatitis, cancer cannot be transmitted from one person to another in this way32,34.
When to See a Doctor
You should see a doctor if your symptoms, such as unexplained fever, fatigue, night sweats, or swelling, persist for more than a few weeks. If routine tests show abnormal blood counts, or if you experience sudden weight loss, unexplained bleeding, or frequent infections, it is best to consult your doctor for prompt medical treatment11,13.
Blood cancers include leukaemia, lymphoma, myeloma, and rarer forms, each with distinct signs such as fatigue, swollen lymph nodes, night sweats, and unexplained bleeding. Early detection allows timely initiation of appropriate treatment like chemotherapy, targeted therapy, immunotherapy, and stem cell transplant, improving cancer control and survival. Always consult your doctor for accurate diagnosis and prompt medical care.
Frequently Asked Questions (FAQs)
How fast does blood cancer progress?
The progression of blood cancer varies depending on the type of blood cancer. Acute blood cancers can worsen within days or weeks, while chronic forms may develop slowly over months or years6.
Can diet or lifestyle help cure blood cancer?
Diet and lifestyle cannot cure blood cancer, but eating nutritious foods, staying active, and avoiding smoking or excessive alcohol can support your overall health and recovery during treatment35.
Is blood cancer contagious?
No, blood cancer is not contagious and cannot spread from person to person. It develops from changes in a person’s own blood-forming cells, not from contact or sharing bodily fluids with a person who has cancer32,33.
What’s the survival rate of blood cancer?
Survival rates for blood cancer vary widely by type, stage, and your body’s response to the treatment. For example, children with AML often respond well to treatment and can achieve high survival rates compared to individuals with more aggressive, advanced cancers15.
Is blood cancer hereditary?
Most cases of blood cancer are not directly inherited, but certain genetic syndromes and family history can increase their risk12,13.
What are the cancer screening tests that help find cancer early?
Cancer screening tests that may help early detection of cancer and improve the chances of survival include mammograms for breast cancer; HPV tests and Pap smears for cervical cancer; colonoscopy, sigmoidoscopy, and stool tests for colorectal (bowel) cancer; and low-dose CT scans for lung cancer5.
Chennamadhavuni A, Lyengar V, Mukkamalla SKR, Shimanovsky A. Leukemia [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560490/
Howell DA, McCaughan D, Smith AG, Patmore R, Roman E. Incurable but treatable: Understanding, uncertainty and impact in chronic blood cancers—A qualitative study from the UK’s Haematological Malignancy Research Network. Soundy A, editor. PLOS ONE [Internet]. 2022 Feb 10;17(2):e0263672. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8830712/
Bhojwani D, Howard SC, Pui CH. High-Risk Childhood Acute Lymphoblastic Leukemia. Clinical Lymphoma and Myeloma [Internet]. 2009 Sep;9:S222–30. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2814411/
Osman AEG, Deininger MW. Chronic Myeloid Leukemia: Modern therapies, current challenges and future directions. Blood Reviews [Internet]. 2021 Mar;49:100825. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8563059/
National Library of Medicine. Adult Non-Hodgkin Lymphoma Treatment (PDQ®): Health Professional Version [Internet]. PubMed. Bethesda (MD): National Cancer Institute (US); 2002. Available from: https://www.ncbi.nlm.nih.gov/books/NBK66057/
Palumbo A, Avet-Loiseau H, Oliva S, Lokhorst HM, Goldschmidt H, Rosinol L, et al. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. Journal of Clinical Oncology [Internet]. 2015 Sep 10;33(26):2863–9. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4846284/
Kaur H, Palot Manzil FF. Nuclear Medicine PET/CT Lymphomas Assessment, Protocols, and Interpretation [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK585116/
Ozkan E, Lacerda MP. Genetics, Cytogenetic Testing And Conventional Karyotype [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563293/
Barcelos MM, Santos-Silva MC. Molecular approach to diagnose BCR/ABL negative chronic myeloproliferative neoplasms. Revista Brasileira de Hematologia e Hemoterapia [Internet]. 201;33(4):290–6. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3415756/
An ZY, Zhang XH. Menin inhibitors for acute myeloid leukemia: latest updates from the 2023 ASH Annual Meeting. Journal of Hematology & Oncology [Internet]. 2024 Jul 19;17(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11264855/
Vishwasrao P, Li G, Boucher JC, Smith DL, Hui SK. Emerging CAR T Cell Strategies for the Treatment of AML. Cancers [Internet]. 2022 Feb 27;14(5):1241. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8909045/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Lobar Pneumonia: What Is It, Causes, Symptoms & Treatment
Introduction
Did you know that pneumonia, a respiratory infection causing inflammation in your lungs, is one of the leading causes of hospitalisation and death in the world1,2?
It is important to remember that early identification of your infection can lead to complete recovery with minimal complications3.
What Is Lobar Pneumonia?
Pneumonia is an infection of the lung tissue causing inflammation in the air sacs (alveoli) of your lungs2,3. Lobar pneumonia is a type of pneumonia in which there is a rapid involvement of an entire section or lobe of your lung by the inflammatory process. However, clinically, the involvement may not always include the entire lobe and may be seen as patchy areas to confluent consolidation (replacement of air with fluid/pus cells in lungs).Typically caused by the bacterium Streptococcus pneumoniae, the condition usually presents in a severe form with a greater possibility of complications4,5.
Note: Lobar pneumonia is a type of pneumonia according to an earlier classification system used for infections of the lower respiratory tract based on X-ray patterns. The current clinical classifications, however, are usually based on the aetiology (causative organism) or whether the infection is community or hospital acquired4.
Causes of Lobar Pneumonia
Are you wondering what causes lobar pneumonia? The causative agents include1,5:
Bacteria: Pneumonia can be caused by gram positive, gram negative, and atypical bacteria1,5.
Gram negative bacteria: Haemophilus influenzae, Klebsiella pneumoniae, and Escherichia coli
Atypical bacteria: Mycoplasma pneumoniae, Chlamydophila pneumoniae, or Legionella species. Results in a patchy or interstitial infiltration but not true lobar consolidation in most cases6.
Viruses: This includes Influenza Type A virus, RSV (Respiratory Syncytial Virus), SARS-CoV-2 (COVID-19) and adenovirus1.
Fungi: While fungal causes of lobar pneumonia are less common than bacterial or viral causes, they mainly occur in immunocompromised individuals. Common organisms include Cryptococcus neoformans, Histoplasma capsulatum, Blastomyces dermatiditis, and Aspergillus fumigatus1.
Persistent cough with or without sputum (Bloody sputum is a classic sign of lobar pneumonia caused by Streptococcus pneumoniae)
High-grade fever with chills
Confusion or delirium
Pleuritic chest pain (sharp pain in your chest which worsens during deep inspiration due to pleural involvement).
Shortness of breath
Vomiting
Abdominal pain
Tiredness or fatigue
Complications such as acute heart failure, shock and meningitis can occur in patients with lobar pneumonia and mortality is also higher4. Thus. if you are facing any of the above-mentioned symptoms, it is ideal to seek medical care and get prompt lobar pneumonia treatment.
Who Is More Likely to Get Lobar Pneumonia?
You are more likely to develop pneumonia if you are8,9,10:
Suffering from any chronic conditions such as diabetes, chronic lung disease, heart disease, etc.
Smoking regularly as smoking impairs your mucociliary clearance and damages epithelial defences.
Consuming alcohol regularly as this is associated with impaired cough reflex, aspiration, and neutrophil dysfunction.
Immunocompromised due to HIV / AIDS or bone marrow transplant.
Exposed to metal fumes (for ex: welder) as this inhalable fume may cause damage to lung defences or the iron in the fume may facilitate the growth of the microorganisms.
Under 5 years of age or above 65 years of age. (Although a study reported men between 40-50 to be more susceptible to lobar pneumonia)4
These risk factors also indicate a higher likelihood of developing lobar pneumonia when you are exposed to causative organisms like Streptococcus pneumoniae.
Congestion (Initial stage): In this stage, the lung becomes swollen and heavy due to an increased blood flow and fluid accumulation. Microscopically, this condition involves vascular engorgement with the alveoli containing proteinaceous fluid, few bacteria and some immune cells.
Red Hepatisation: Due to capillary damage, your red blood cells and white blood cells called neutrophils leak into the alveolar spaces. The lung becomes firm like liver due to the increased neutrophils, fibrinous exudate, and red blood cells. Hence, this stage is referred to as hepatisation (liver-like).
Grey Hepatisation: The characteristic grey appearance in this stage is due to the breakdown of the red blood cells and the accumulation of fibrin, neutrophils and special immune cells known as macrophages.
Resolution (Recovery): The body starts to clean up the infection. The macrophages are the main cells in this stage and help to remove the leftover debris. The lung may return to normal, however, in some cases, a small amount of scar tissue remains.
Diagnosis of Lobar Pneumonia
To diagnose lobar pneumonia, your doctor may suggest3,11:
Chest X-ray: Key diagnostic tool for lobar pneumonia. Your chest X-ray may show segmental, homogenous consolidation of one or more lobes with visible air bronchogram (air-filled bronchi visible within the consolidated lung)1.
Computed Tomography: Helpful in cases which are unclear.
Blood Tests: These include:
Complete blood count: Elevated creatinine and white blood cells count indicates infection. Elevated erythrocyte sedimentation rate and C-reactive protein suggest inflammation. Although these are non-specific markers and cannot confirm pneumonia, they can support the diagnosis when elevated.
Arterial blood gases: Useful in severe cases such as hypoxia (low oxygen supply to tissues) and respiratory acidosis (acidic blood due to the presence of carbon dioxide).
Sputum Culture: Maybe advised in severe or hospitalised cases to identify the bacteria causing your illness. However, it is not always reliable, and confirmation of pneumonia requires correlation with clinical history and gram staining.
Liver function tests: Abnormal liver function tests are common in cases of community acquired pneumonia12.
Urinary Antigen Test: Can help to identify Streptococcus pneumoniae and Legionella pneumophila, the main causative organisms of lobar pneumonia13.
Gram Staining: To identify the causative organism. For example: Gram positive cocci may indicate Streptococcus pneumoniae, whereas gram-negative bacilli may indicate Haemophilus influenzae.
Respiratory Viral Panel: A secondary bacterial infection is common following a viral infection. This test is done by collecting a sample from your respiratory tract (nasopharyngeal swab) and helps to check for viral pathogens such as influenza, RSV or SARS-CoV-2.
A timely and accurate diagnosis of lobar pneumonia is necessary to guide appropriate treatment.
Treatment Options
The main treatment for lobar pneumonia involves the use of antibiotics.
For healthy individuals without any underlying health issues, the commonly prescribed antibiotics include3,11:
Amoxicillin(preferred for Streptococcus pneumoniae)
Doxycycline and macrolides may be preferred for atypical pathogens such as Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella species.
For individuals with chronic conditions, such as diabetes or heart disease, the treatment often involves3,11:
Combination of beta lactam antibiotic (high dose amoxicillin or amoxicillin-clavulanate, cefuroxime) along with a macrolide (such as azithromycin or clarithromycin) or doxycycline
Alternatively, your doctor may recommend a single stronger antibiotic like respiratory fluoroquinolone (such as levofloxacin or moxifloxacin). While respiratory fluoroquinolones are acceptable alternatives, it is important to note that overuse may lead to resistance and increased risk of Clostridium difficile infection14.
For hospitalized patients with moderate illness, doctors may recommend3,11:
A beta lactam antibiotic (such as ceftriaxone) along with a macrolide (such as azithromycin).
Your doctor may alternatively suggest the use of a single respiratory fluoroquinolone (such as levofloxacin).
If you are admitted to the hospital and your pneumonia is severe, your treatment will be more intensive and usually includes3,11:
A beta lactam antibiotic plus a macrolide
Empirical treatment may also require coverage for Methicillin Resistant Staphylococcus aureus (MRSA) or pseudomonas. In these cases, adding vancomycin or linezolid for suspected MRSA or anti-pseudomonal beta-lactams for high-risk patients15.
Alternatively, your doctor may recommend a beta lactam antibiotic along with a respiratory fluoroquinolone.
Note: Macrolide monotherapy is not recommended in areas with high macrolide-resistant Streptococcus pneumoniae.
Timeline for Recovery
Most people with lobar pneumonia symptoms start to show signs of recovery within 5 to 7 days, if they respond well to treatment (fever is gone for 2-3 days, no longer need oxygen, and their breathing and blood pressure have returned to normal)16.
However, depending on the causative agent, you may require a longer treatment time. For example, your lobar pneumonia is generally severe when caused by Legionella pneumonia, so you would require approximately 10-14 days to recover. Similarly for Staphylococcus aureus infection, a longer treatment duration of 14-21 days approx. will be required, especially in cases of MRSA infection16.
Moreover, if you develop any complications such as fluid buildup in your lungs (empyema), lung abscess, or lung tissue damage (necrosis), your treatment may take longer to complete. Hence, your total treatment time and recovery is dependent on how fast your symptoms improve, the causative organism and any complications3,11.
Managing Lobar Pneumonia at Home
Home management of pneumonia is appropriate for non-severe, stable patients. If pneumonia follows a viral infection like influenza or due to a pathogen with potential spread like Mycoplasma, it might be ideal to isolate from early on. Simple self-care measures that you can follow to manage lobar pneumonia at home include2:
Getting plenty of rest: Try to stay and rest at home and avoid contact with other people, and if you do not feel well enough.
Staying hydrated: It is important to drink plenty of fluids and stay hydrated.
Following good hygiene practices: Wash your hands regularly with warm water and soap, throw used tissues in the bin, and cover your mouth while sneezing or coughing.
Isolating yourself: Following social distancing or isolating early in the course of illness can be helpful in preventing spread especially if pneumonia is associated with a viral infection or due to an atypical organism.
Using over-the-counter pain relievers: You may take paracetamol or ibuprofen if you are having pain or a very high temperature. But ideally consult your doctor before prolonged use, particularly if you have any condition where the renal function may be affected.
Taking medications: Use your medications exactly as prescribed by your doctor.
If your symptoms worsen or do not improve after a few days of treatment, consulting your doctor is important2.
Lobar Pneumonia in the Elderly
Lobar pneumonia in elderly individuals can be a serious condition as they have a higher risk of complications due to age-related weakening of immune system and chronic medical conditions.
Moreover, elderly individuals may not even show symptoms or have atypical ones like increasing confusion, loss of consciousness, and low blood pressure along with high-grade fever and increased heart rate. Hence, it is important to promptly and correctly diagnose pneumonia in these individuals and start treatment early, following medical guidelines closely to reduce further complications.
Simple steps, such as getting vaccinated against pneumonia, flu, and quitting smoking, can help to lower the risk and reduce the severity of infection in elderly people17.
Prevention Strategies
Prevention strategies to reduce your risk of pneumonia include3,11,18,19:
Get Vaccinated:
Pneumococcal vaccination: PCV 15/PCV20 are conjugate vaccines while PPSV23 is a polysaccharide vaccine. It provides vaccination against Streptococcus pneumoniae, the main aetiological agent of lobar pneumonia. It is recommended in all children under 5 years of age, and in individuals with chronic conditions like diabetes, chronic lung disease, etc.In immunocompetent adults above 65 years or adults with comorbidities, vaccination with either a single dose of PCV20 or PCV15 is recommended, followed by PPSV23 after 1 year20,21.
Pertussis vaccination (DTaP / Tdap Vaccination): The pertussis vaccine helps to protect against pertussis, a highly contagious bacterial infection that causes severe coughing fits24.
Good hand hygiene practices Follow simple steps like regularly washing your hands with warm water and soap.
Avoiding smoking By smoking you not only damage your lungs but also weaken your immune system, thereby increasing your risk of lobar pneumonia.
Management of chronic conditions such as asthma, diabetes, or heart disease by ensuring prompt medical care and taking medications as directed.
Strengthening your immune system by staying physically active and following a healthy diet.
Avoiding close contact with sick individuals, avoiding crowds and practicing sneezing or coughing into a tissue or your elbow.
By following these steps, you can reduce your risk of developing lobar pneumonia.
When to See a Doctor
You should visit your doctor if you are experiencing cough for more than three weeks, or if you have shortness of breath which is getting worse, or if you are coughing up blood or if you are experiencing chest pain (especially increased pain when you breathe or cough)2.
Early diagnosis and treatment of lobar pneumonia are important to reduce complications and support recovery2.
Conclusion
Lobar pneumonia is a serious lung infection that can affect an entire lobe of your lung. Early recognition and timely treatmentare essential to avoid complications. Simple measures like vaccination, good hygiene, and managing chronic conditions can reduce your risk of developing lobar pneumonia. If your symptoms worsen or persist, you should seek prompt medical attention.
Frequently Asked Questions (FAQs)
What are the complications of lobar pneumonia?
Lobar pneumonia can cause complications such as pleural effusion (fluid around the lungs), empyema (pus in the pleural space), lung abscess (pus-filled cavity), or respiratory failure. In severe cases, it may lead to spread of infection to other organs1.
What is the difference between lobar pneumonia and bronchopneumonia?
Lobar pneumonia affects an entire lobe of the lung with uniform consolidation, while bronchopneumonia involves patchy inflammation around the bronchi and may affect multiple lobules of your lungs9.
Is lobar pneumonia more common in any specific season?
Yes, lobar pneumonia is more common during the winter and early spring seasons. Respiratory infections are more common during this season and presence of crowds increases the risk of transmission8.
Can lobar pneumonia be contagious?
Yes, as lobar pneumonia is caused by bacteria or viruses that spread through inhalation of infected respiratory droplets from coughing, sneezing, or close contact with an infected person25.
References
Franquet T. Imaging of Community-acquired Pneumonia. Journal of Thoracic Imaging [Internet]. 2018 Sep;33(5):282–94. Available from: https://pubmed.ncbi.nlm.nih.gov/30036297/
Zinserling VA, Swistunov VV, Botvinkin AD, Stepanenko LA, Makarova AE. Lobar (croupous) pneumonia: old and new data. Infection [Internet]. 2021 Sep 1;50. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8409273/
Bradley SF. Alcohol Use Disorder and Risk of Pneumonia. JAMA Network Open [Internet]. 2019 Jun 7 [cited 2019 Oct 17];2(6):e195179. Available from: https://pubmed.ncbi.nlm.nih.gov/31173114/
Pahal P, Rajasurya V, Sharma S. Typical Bacterial Pneumonia [Internet]. National Library of Medicine. StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534295/
Jinks MF, Kelly CA. The pattern and significance of abnormal liver function tests in community-acquired pneumonia. European Journal of Internal Medicine [Internet]. 2004 Nov 1;15(7):436–40. Available from: https://www.ejinme.com/article/S0953-6205(04)00191-8/pdf
Kim P, Deshpande A, Rothberg MB. Urinary Antigen Testing for Respiratory Infections: Current Perspectives on Utility and Limitations. Infection and Drug Resistance [Internet]. 2022 Apr;Volume 15:2219–28. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9058651/
Shea KM, Hobbs ALV, Jaso TC, Bissett JD, Cruz CM, Douglass ET, et al. Effect of a Health Care System Respiratory Fluoroquinolone Restriction Program To Alter Utilization and Impact Rates of Clostridium difficile Infection. Antimicrobial Agents and Chemotherapy [Internet]. 2017 Jun;61(6). Available from: https://journals.asm.org/doi/10.1128/aac.00125-17
VanEperen AS, Segreti J. Empirical therapy in Methicillin-resistant Staphylococcus Aureus infections: An Up-To-Date approach. Journal of Infection and Chemotherapy [Internet]. 2016 Jun 1;22(6):351 Available from: https://pubmed.ncbi.nlm.nih.gov/27066882/
Dimitra Dimopoulou, Moschopoulos CD, Konstantina Dimopoulou, Dimopoulou A, Berikopoulou MM, Ilias Andrianakis, et al. Duration of Antimicrobial Treatment in Adult Patients with Pneumonia: A Narrative Review. Antibiotics [Internet]. 2024 Nov 12;13(11):1078–8. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11591184/
National Heart, Lung, and Blood Institute. Pneumonia: What needs to be considered in older people? [Internet]. NCBI. Institute for Quality and Efficiency in Health Care (IQWiG); 2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525776/
Gilsdorf JR. Hib Vaccines: Their Impact on Haemophilus influenzae Type b Disease. The Journal of Infectious Diseases [Internet]. 2021 Sep 30;224(Supplement_4):S321–30. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8482018/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
Pneumonia in the Elderly: Causes, Symptoms, Treatment, and Prevention
Introduction
As people get older, they become more susceptible to infections, and a common one is the lung infection called pneumonia. It happens when bacteria, viruses, fungi or other uncommon germs enter the lungs. In the elderly, the body’s defence system becomes weak, so germs can easily enter the airways1,2. This leads to infection in the lungs where a thick fluid called inflammatory exudate, made up of immune cells, proteins and germs build up in the air spaces, causing trouble in breathing and symptoms like cough and chest pain2,3.
It is a serious concern in older people because the illness can get worse quickly, and recovery becomes more difficult. They are more likely to get a severe form of pneumonia and need hospital admission4. There are chances of death also, seen in about 5 to 15% of people admitted to the hospital, and it can rise to 30 to 50% in those who are seriously ill and need intensive care1.
But it can be managed better if we know about symptoms of pneumonia in elderly, how it is treated, and how it can be prevented, which we will discuss further in this blog5.
Types of Pneumonia in the Elderly
Pneumonia in elderly is grouped based on where and how they catch the infection. The common types are:
Community-acquired pneumonia: This happens outside hospitals, when bacteria or viruses spread through coughing or sneezing. It could also include places like old age homes, rehab centres, or other care facilities. In some elderly people, it may also occur when food, drink, or saliva accidentally enters the lungs instead of the stomach (known as aspiration pneumonia).
Hospital-acquired pneumonia: When pneumonia is seen in a person has after they have stayed in a hospital or healthcare setting for at least 2 days, it is called hospital-acquired pneumonia. This means the infection started in the hospital and was not present when the person was first admitted.
Ventilator-associated pneumonia: This develops in patients who are put on a breathing support machine like a ventilator. If pneumonia starts 48 hours or more after the tube is placed into the windpipe, it is called ventilator-associated pneumonia.
All these types of pneumonia in elderly may be caused by either a bacterium, a virus, a fungus, or a parasite that has infected the lungs2,6. Let us see what causes these types of pneumonia in the next section.
What Causes Pneumonia in the Elderly?
Bacteria are the most common cause of pneumonia in elderly population. It can happen mainly in two ways: • By accidentally breathing in food or stomach contents (aspiration pneumonia) • By catching the infection from air or people around (airborne pneumonia)
Here is a table that shows what causes pneumonia in elderly and how they spread6,7:
Among these, Streptococcus pneumoniae is the most common bacteria seen in elderly patients.
Some elderly people may get infected with strong germs that do not respond to certain antibiotics. These are hard to treat and are often seen in those who had pneumonia earlier, are admitted to the hospital often, or received injectable antibiotics in the last 90 days6.
There are other risk factors that make elderly people more likely to get pneumonia, which will be discussed in detail in the next section.
Risk Factors for Pneumonia in the Elderly
As the body ages, the immune system becomes slower, and other health issues and some medicines can increase the risk of pneumonia, as given below:
Weak immune system: With age, the body can’t make strong immune cells to fight infections. At risk are those with weak immunity, those having cancer, kidney problems, or taking medicines that lower immunity, or those without a spleen (typically due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis)5,8.
Health issues: Problems like COPD, heart disease, liver issues, or diabetes can make the lungs weak. In COPD, damaged airways, excess mucus, and changes in lung bacteria make it easier for infections to grow5,9.Liver disease alters the immune system and affects the body’s ability to clear lung infections. In heart disease, fluid gets built-up in the lungs, which may slow down the removal of bacteria and affect the lung’s defence system10,11.
Lifestyle: Being male, poor diet, not drinking enough water, pollution, alcohol, smoking, or staying in old-age homes can add to the risk.
Medicines: Drugs for mental health, sleep, acidity, allergy, or steroids can raise the risk. Some mental health medicines (like antipsychotics) and sleeping pills (like opioids or benzodiazepines) can make the body slow down and increase the chance of food or fluid entering the lungs. This can lead to a type of lung infection called aspiration pneumonia. Acidity medicines like PPIs (e.g., omeprazole, lansoprazole) may also weaken the body’s defence by affecting immune cells, making it harder to fight infections5,12.
Elderly people who lie flat for long periods, have trouble swallowing, use feeding tubes, are very drowsy, or have poor mouth hygiene are at risk of getting aspiration pneumonia. Tumours in the mouth or airways can also raise the risk5.
Symptoms of Pneumonia in the Elderly
Symptoms of pneumonia in elderly individuals may not always be typical, and only some may have common signs like:
Cough
Breathing difficulty
Mild fever (occasionally)
Others may just show vague symptoms. These include:
Sometimes, other signs like sudden falls may be seen. These are not direct symptoms of pneumonia, but when the infection spreads in the body, it can cause weakness, dizziness, or low blood pressure, leading to falls.
In people with existing heart or lung conditions, pneumonia can make those illnesses worse, even if they are not symptoms of pneumonia itself5,15.
If such symptoms appear, doctors may suspect pneumonia. A fast breathing rate (over 25 per minute) or low oxygen (below 90%) may suggest infection. However, low oxygen is not specific to pneumonia, it shows that the lungs are not working properly, and the illness may be severe. To confirm, imaging tests like X-ray or CT scan and blood tests may be done. Treatment will be started early5,13.
Treatment for Pneumonia in the Elderly
Treatment for pneumonia in older people is planned based on how severe the condition is and where the person is being treated, either at home or in the hospital. The table below shows common treatments depending on the patient’s condition5,13.
Patient Condition
Medicines Commonly Given
Treated at home with no other health problems
Antibiotics like amoxicillin are commonly used, especially if Streptococcus pneumoniae is expected. Azithromycin or doxycycline may also be used, but azithromycin alone is not preferred in areas where resistance is high.
Treated at home but has other health issues
Combination of two antibiotics like amoxicillin with azithromycin can be given. Or a single broad antibiotic like levofloxacin may also be given.
Admitted to hospital but not in ICU
Same as above but given through a vein (IV) and under close watch. Usually a beta-lactam antibiotic like ceftriaxone with azithromycin, or just a strong one like levofloxacin.
Admitted to ICU but no risk of severe infections
Strong antibiotics like ceftriaxone or cefepime, with azithromycin or levofloxacin. Doctors also check if any resistant organisms like MRSA or Pseudomonas are possible.
Lungs have pus or fluid buildup like abscess or empyema
Strong antibiotics or special ones like clindamycin may be added, especially if food or fluid accidentally entered the lungs.
Along with antibiotics, in severe cases, steroids are given to calm the immune system. Oxygen and IV fluids help with breathing and hydration. Patient is watched closely to see if they get better or have any issues. Recovery depends on how well they respond to the treatment5,13.
Recovery from Pneumonia in the Elderly
Recovery from pneumonia in older people is often slower compared to younger people. If the treatment for pneumonia in elderly is in the hospital, it may take up to 8 weeks or longer to fully recover, while people treated at home may feel better sooner. Even after the person feels better, the chest X-ray may still show signs of infection. This is common in older people and does not always mean the pneumonia is still active13.
Avoid smoke or wood fires, as they can irritate the lungs.
Do breathing exercises as advised by doctor. Chest physiotherapy is usually recommended only in people with lung conditions like COPD or when it is hard to clear mucus1,3.
Recovery also depends on the person’s ability to do daily activities. Those who are weak or have other health issues may take longer to recover and may face complications1,13.
Complications of Elderly Pneumonia
In people who are very old and frail and have other diseases like heart or kidney problems, pneumonia recovery can be hard, and complications may occur.
The infection can spread and cause sepsis, which could be seen as one of first signs of pneumonia in elderly
Lung damage such as pus collection (empyema) or severe tissue damage (necrotizing pneumonia) or abscess can occur
Heart failure or clots in the legs/ lungs can occur due to low oxygen, poor movement, or inflammation
Some may eat less and face a nutritional drop
These problems are common in elderly pneumonia when not treated early. Symptoms like confusion or delirium may lead to poor outcomes2,6.
How to Prevent Pneumonia in Older Adults
Pneumonia in elderly individuals can be dangerous with complications, but by preventing it, you can make sure you’re ageing healthily and maintain your quality of life. Here are some ways how to prevent pneumonia in elderly:
Vaccines: Get vaccinated against pneumococcal bacteria, flu virus, and COVID-19. Flu vaccine is for all ages, but people above 65 should take it every year. Pneumococcal vaccine (PCV) may be given to people above 65 as either one shot (PCV20) or two shots (PCV15 followed by PPSV23).
Lifestyle changes: Quit alcohol and smoking. Take care of problems like trouble swallowing, poor nutrition, and oral hygiene. Also, get your medicines checked to see if they increase pneumonia risk. Do breathing exercises and keep your body moving as physical activity helps reduce risk.
Good hygiene: Wash your hands with soap and water regularly. Cover your mouth and nose while coughing or sneezing.
Manage ongoing health problems: Conditions like COPD, heart failure, and diabetes should be treated well to prevent pneumonia3,15.
So, by getting vaccines, following infection control, and managing chronic illnesses, you can reduce the risk of pneumonia.
When Should You See a Doctor?
The following symptoms of pneumonia in elderly people require medical attention:
Fever
Cough
Breathing difficulty
Chest pain
Feeling confused or very tired
Signs like trouble breathing, bluish lips, or low blood pressure need urgent care.
Especially those who have heart disease, diabetes, or kidney problems should not wait but see the doctor early so they can avoid complications and recover faster3,16.
Pneumonia in older people can be serious and even life-threatening if not treated early. However, with the right medicines, along with good nutrition, proper care for existing health problems, and support for any complications, pneumonia in elderly can show good recovery. Closely watch for symptoms like cough, fever, breathing trouble, or confusion. So, knowing the signs and risks helps you visit the doctor in time and start appropriate treatment to avoid any complications of pneumonia from occurring.
If you are older and have poor dental hygiene, you may be at risk of getting pneumonia. When you do not brush properly, bacteria can build up in the mouth. These bacteria can accidentally enter the lungs and cause pneumonia6.
Is my nutrition affected when I get pneumonia?
Yes, pneumonia can affect your nutrition. The illness causes your body to use up nutrients faster, and many people eat less when they are sick. This can lead to poor nutrition, which may slow recovery and lead to worse outcomes6.
Why do some older people get aspiration pneumonia?
People who have trouble swallowing, lie down for long hours, use feeding tubes or oxygen, take painkillers, or have poor mouth hygiene are more likely to get aspiration pneumonia5.
What does a geriatrician do for an older person with pneumonia?
Yes, a geriatrician checks for problems that can make pneumonia worse, like poor nutrition, weakness, memory loss, or confusion. They address these issues early, give the right support and medical care, and help reduce the risk of getting pneumonia6.
References
Chebib N, Cuvelier C, Malézieux-Picard A, Parent T, Roux X, Fassier T, et al. Pneumonia prevention in the elderly patients: The other sides. Aging Clinical and Experimental Research. 2019 Dec 31;33(1). https://link.springer.com/article/10.1007/s40520-019-01437-7
Li W, Ding C, Yin S. Severe pneumonia in the elderly: a multivariate analysis of risk factors. International Journal of Clinical and Experimental Medicine [Internet]. 2015 Aug 15;8(8):12463. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4612842/
Restrepo MI, Sibila O, Anzueto A. Pneumonia in Patients with Chronic Obstructive Pulmonary Disease. Tuberculosis and Respiratory Diseases [Internet]. 2018;81(3):187–97. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6030662/
Xu L, Ying S, Hu J, Wang Y, Yang M, Ge T, et al. Pneumonia in patients with cirrhosis: risk factors associated with mortality and predictive value of prognostic models. RESPIRATORY RESEARCH. 2018 Dec;19(1). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6280505/
Shen L, Jhund PS, Anand IS, Bhatt AS, Desai AS, Maggioni AP, et al. Incidence and Outcomes of Pneumonia in Patients With Heart Failure. Journal of the American College of Cardiology [Internet]. 2021 Apr 27 [cited 2021 Sep 18];77(16):1961–73. Available from: https://pubmed.ncbi.nlm.nih.gov/33888245/
Manian FA, Hsu F, Huang D, Blair A, Mosarla R, Mulugeta W, et al. Coexisting Systemic Infections in Patients Hospitalized Because of a Fall: Prevalence and Risk Factors. The Journal of Emergency Medicine. 2020 May;58(5):733–40. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0736467920300214
Antje Häder, Nilay Köse-Vogel, Schulz L, Lucja Mlynska, Hornung F, Hagel S, et al. Respiratory Infections in the Aging Lung: Implications for Diagnosis, Therapy, and Prevention. Aging and Disease. 2024 Jan 1;14(4):1091–104. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10389836/#sec11
Institute for Quality and Efficiency in Health Care. Pneumonia: What needs to be considered in older people? [Internet]. Nih.gov. Institute for Quality and Efficiency in Health Care (IQWiG); 2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525776/
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
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