Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.
Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.
One of the minerals that is important in the regulation
and processes of many body functions including bone formation, hormone release,
muscle contraction, and nerve and brain function is
calcium. If levels of calcium in the body are
elevated above what is considered normal, this is referred to as hypercalcemia.
Calcium levels in the body are tightly regulated. The regulation of calcium
is primarily controlled by vitamin D, calcitonin, and parathyroid hormone (PTH).
Calcitonin is produced in specialized cells in the
thyroid gland.
Vitamin D is obtained through a process that begins
with sun exposure to the skin. The process then continues in the liver and kidneys. Vitamin D can
also be found in foods, such as eggs and dairy products.
Parathyroid hormone is a hormone produced by the
parathyroid glands, which are four small glands surrounded by the thyroid and
found in the anterior part of the lower neck.
Together, the parathyroid hormone, calcitonin, and vitamin D regulate calcium
levels in the bloodstream via the kidneys, and the intestinal tract.
Hypercalcemia Causes
The most common cause of high calcium levels
(hypercalcemia) is an overproduction of parathyroid hormone, or
hyperparathyroidism. Hyperparathyroidism tends to be more common in women, and
occurs in 25 out of every 100,000 individuals. Hyperparathyroidism can be the
result of all four parathyroid glands producing an excessive amount of
parathyroid hyperplasia (PTH), or the result of just one gland specifically producing an excessive
amount of PTH (usually the result of a parathyroid adenoma or
benign tumor).
Other medical conditions can be associated with high calcium levels
(non-parathyroid hypercalcemia). Some of these conditions are not serious;
however, they may vary in severity and chronicity. For example, hypocalciuric
hypercalcemia is an inherited condition in which individuals do not excrete
normal amounts of calcium, thus calcium levels are usually slightly elevated.
Patients with hypocalciuric hypercalcemia have little or no symptoms so it is
generally discovered incidentally through routine blood tests. Other causes of
hypercalcemia can be life-threatening. Cancers are commonly associated with
elevated calcium levels and are referred to as "hypercalcemia of malignancy."
Twenty to forty percent of patients with cancer will develop hypercalcemia at
some point in their disease.
Other conditions associated with hypercalcemia include:
Constipation occurs commonly in children, affecting up to 10% at any given time. Still, only 3% of parents actually seek advice from the doctor for this condition. Constipation describes the infrequent passage of stools (bowel movements) or the passage of hard stools. Any definition of constipation depends upon comparison
with how often the child normally passes stools and with the usual consistency of his or her stools.
Many children normally pass stools as far apart as every few days. Regardless, you should treat hard stools that are difficult to pass and those that happen only every
three days as constipation.
Constipation in Children Causes
Infants and children with constipation are treated differently than adults, because patterns of bowel movements change from the time they are born until they reach the age of 3 or 4 years. The majority of children with constipation do not have a me...
