Alcohol Use Disorder (AUD)

What is alcohol use disorder (AUD)?

For most adults, moderate alcohol use is probably not harmful. Your risk of developing an alcohol use disorder (AUD) depends on how much, how often, and how quickly you drink alcohol. Alcohol misuse means that drinking causes distress and harm. Over time alcohol misuse can increase your risk of AUD.

AUD can range from mild to severe, depending on the symptoms. Severe AUD is sometimes called alcoholism or alcohol dependence.

AUD is a disease that causes:

• Craving - a strong need to drink
• Loss of control - not being able to stop drinking once you've started
• Negative emotional state - feeling anxious and irritable when you are not drinking

Binge drinking is a type of alcohol misuse. It means drinking so much at once that your blood alcohol concentration (BAC) level is 0.08% or more. For a man, this usually happens after having 5 or more drinks within a few hours. For a woman, it is after about 4 or more drinks within a few hours. Not everyone who binge drinks has an AUD, but they are at higher risk for getting one.

Too much alcohol is dangerous. Heavy drinking can increase the risk of certain cancers. It may lead to liver diseases, such as alcohol-associated liver disease (ALD) and cirrhosis. It can also cause damage to the brain and other organs. Drinking during pregnancy can harm your fetus. Alcohol also increases the risk of death from car crashes, injuries, homicide, and suicide.

You may have an AUD if you can answer yes to two or more of these questions:

In the past year, have you:

• Ended up drinking more or for a longer time than you had planned to?
• Wanted to cut down or stop drinking, or tried to, but couldn't?
• Spent a lot of your time drinking or recovering from drinking?
• Felt a strong need to drink?
• Found that drinking - or being sick from drinking - often interfered with your family life, job, or school?
• Kept drinking even though it was causing trouble with your family or friends?
• Given up or cut back on activities that you enjoyed just so you could drink?
• Gotten into dangerous situations while drinking or after drinking? Some examples are driving drunk and having unsafe sex.
• Kept drinking even though it was making you feel depressed or anxious? Or when it was adding to another health problem?
• Had to drink more and more to feel the effects of the alcohol?
• Had withdrawal symptoms when the alcohol was wearing off? They include trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, and sweating. In severe cases, you could have a fever, seizures, or hallucinations.

If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more serious the problem is.

If you think you might have an AUD, see your health care provider for an evaluation. Your provider can help make a treatment plan, prescribe medicines, and if needed, give you treatment referrals.

NIH: National Institute on Alcohol Abuse and Alcoholism

Anal Disorders

What is the anus?

Your anus is the opening at the end of your large intestine. It is where stool (poop) leaves your body.

Problems with the anus are common. They include:

• Hemorrhoids
• Abscesses
• Fissures, small cracks or tears in the lining of your anus
• Anorectal fistula, an abnormal tunnel from your anus or rectum to the skin surface
• Anal itching (pruritus ani)
• Cancer

Your symptoms will depend on which disorder you have. But some of the more common symptoms may include:

• Bleeding
• Discharge
• Itching
• Pain
• Swelling

To make a diagnosis, your health care provider will ask about your symptoms and medical history. Depending upon your symptoms, your provider may:

• Check the skin around your anus for anything that looks abnormal.
• Perform a digital rectal exam (DRE). For this exam, your provider inserts a lubricated, gloved finger into the lower part of your rectum to feel for lumps or anything unusual.
• Order tests, such as an anoscopy.

You may be embarrassed to talk about your anal troubles. But it's important to let your provider know about your symptoms, especially if you have pain or bleeding. The more details you can give about your problem, the better your provider can help you.

Treatments vary, depending on the condition you have.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Aplastic Anemia

What is aplastic anemia?

Aplastic anemia is a rare but serious blood disorder. If you have it, your bone marrow doesn't make enough new blood cells. It happens when there is damage to stem cells inside your bone marrow. There are different types of aplastic anemia, including Fanconi anemia.

The causes of aplastic anemia can include:

• Autoimmune disorders, which are the most common cause
• Certain inherited gene changes, such as the one that can cause Fanconi anemia
• Toxic substances, such as pesticides, arsenic, and benzene
• Radiation therapy and chemotherapy for cancer
• Certain medicines
• Viral infections such as hepatitis, Epstein-Barr virus, or HIV
• Pregnancy

In many people, the cause is unknown. This is called idiopathic aplastic anemia.

Aplastic anemia can develop suddenly or slowly. It can be mild or severe. The symptoms of aplastic anemia can include:

• Fatigue
• Weakness
• Dizziness
• Shortness of breath
• Easy bruising or bleeding

Aplastic anemia can cause other problems, including frequent infections and bleeding. It raises your risk of developing a serious blood disorder.

If not treated, aplastic anemia can also lead to heart problems such as an arrhythmia (a problem with the rate or rhythm of your heartbeat), an enlarged heart, or heart failure.

To find out if you have aplastic anemia, your doctor will:

• Take your medical and your family medical histories
• Do a physical exam
• Order tests, such as tests to check if you have low numbers of cells in your bone marrow and blood

If you have aplastic anemia, your doctor will create a treatment plan for you. The plan will be based on how severe the anemia is and what is causing it. Treatments can include:

• Blood transfusions
• Blood and marrow stem cell transplants
• Medicines to suppress your immune system

Because of the risk of blood disorders, your doctor will monitor your condition and screen you for blood disorders regularly.

NIH: National Heart, Lung, and Blood Institute

Arsenic

Arsenic is a natural element found in soil and minerals. Arsenic compounds are used to preserve wood, as pesticides, and in some industries. Arsenic can get into air, water, and the ground from wind-blown dust. It may also get into water from runoff.

You may be exposed to arsenic by:

• Taking in small amounts in food, drinking water, or air
• Breathing sawdust or burning smoke from arsenic-treated wood
• Living in an area with high levels of arsenic in rock
• Working in a job where arsenic is made or used

Exposure to arsenic can cause many health problems. Being exposed to low levels for a long time can change the color of your skin. It can cause corns and small warts. Exposure to high levels of arsenic can cause death.

Agency for Toxic Substances Disease Registry

Artificial Limbs

People can lose all or part of an arm or leg for a number of reasons. Common ones include:

• Circulation problems from atherosclerosis or diabetes. They may cause you to need an amputation.
• Traumatic injuries, including from traffic accidents and military combat
• Cancer
• Birth defects

If you are missing an arm or leg, an artificial limb can sometimes replace it. The device, which is called a prosthesis, can help you to perform daily activities such as walking, eating, or dressing. Some artificial limbs let you function nearly as well as before.