How Common Is Shingles
Shingles is an infection of a nerve and the area of skin supplied by the nerve. It is caused by a virus called the varicella-zoster virus. It is the same virus that causes chickenpox. Anyone who has had chickenpox in the past may develop shingles. Shingles is sometimes called herpes zoster.
About 1 in 4 people have shingles at some time in their lives. It can occur at any age but it is most common in older adults . After the age of 50, it becomes increasingly more common as you get older. It is uncommon to have shingles more than once but some people do have it more than once.
Can Other People Catch Shingles
This one is confusing! You can catch chickenpox from other people, but you can’t catch shingles from other people. You only get shingles from a reactivation of your own chickenpox infection in the past.
So if you have shingles, and you come into contact with somebody else, they cannot ‘catch’ your shingles. But if they have never had chickenpox, it is possible that they could catch chickenpox from you.
To put it another way, no, you don’t ‘catch’ shingles. It comes from a virus hiding out in your own body, not from someone else. But if you have shingles, you may be infectious, as it is possible for people to catch chickenpox from you.
Only people who have never had chickenpox are likely to be at risk of catching chickenpox from your shingles. People who have had chickenpox should be immune from catching it again. If the rash is in a covered area of skin, the risk of anyone with whom you are not in close contact catching chickenpox is very low.
Enteric Zoster: Hidden Shingles Threat
Characterized by severe abdominal pain.
A diagnosis of herpes zoster typically relies on the appearance of the classic blistering skin rash associated with the condition. Occasionally, however, there is no rash-a situation known as zoster sine herpete. Such is the case with enteric zoster.
Traditionally, the accepted teaching has been that the varicella zoster virus reactivates only in sensory nerve cells located on the dorsal roots of spinal nerves and cranial nerves. What we now know is that the virus also becomes latent in nerve cells in other regions of the body, the so-called autonomic nerves and the enteric nervous system, says neurobiologist Michael Gershon, MD and professor in the Department of Pathology and Cell Biology at Columbia Universitys Vagelos College of Physicians and Surgeons.
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Gershon and his wife, pediatrician Anne Gershon, MD, have researched and their findings on VZV and its effect on the enteric nervous system. They note that when the virus reactivates in neurons that project to the skin, it produces the tell-tale rash. But if it reactivates in enteric neurons, it can cause a painful gastrointestinal disorder.
In the absence of rash, nobody ever suspected shingles, explains Gershon.
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Stomach/digestive Issues With Shingles
Has anyone has stomach or intestinal symptoms along with their shingles?
It feels like I have gastritis or colitis or something. Bloating, gas, burping, abdominal pain kind of all over, diarrhea. As if the shingles/pain werent bad enough! Also having some lightheaded ness which I feel is the virus in the ear area since I have facial/head tingling. If so, what do you do for the stomach discomfort?
4 years ago
I had exactly the same thing. I took a probiotic every day and followed each meal with 100g of probiotic yoghurt. The symptoms cleared in about a week.
Hope this helps
Posted 4 years ago
Thank you! I have been afraid to eat much for fear of the awful cramps! I am already taking culturelle and florastor daily, but I will add the yogurt and see if that helps.
Posted 4 years ago
I had severe nausea with it, so bad that I could not eat anything other than jello and had to have a Rx of Phenergan, which knocked me out. It lasted 2 weeks. From beginning to end , I was sick for almost 4 months. Still not 100% and dont think I ever will be.
Posted 4 years ago
My doctor prescribed me Zofran for the nausea. It helps a little with that symptom. I am afraid to eat much of anything at all due to the nausea and cramps. My bout with shingles has lasted since last July. Ugh! Hope you feel better soon! I hope we all do!! Thanks for the tips!
Thanks for your help!
Month Three To Multiple Years: Long
Most peoples pain decreases within two to three months, but for some the pain lingers longer. That persistent pain, called postherpetic neuralgia, is the most common complication of shingles, impacting up to 18% of folks with the infection. PHN develops when nerve fibers are damaged at the site of the shingles rash. The pain may be constant or intermittent, moderate, severe or even incapacitatingand it may last for months or even years. Its experienced as burning, itching, a stabbing pain or an altered sensation, says Dr. Rosen. While anyone can suffer with post herpetic neuralgia, your risk increases with age and with a history of chronic illness, such as asthma or diabetes.
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Steroid Medication For Shingles
Steroids help to reduce swelling . A short course of steroid tablets may be considered in addition to antiviral medication. This may help to reduce pain and speed healing of the rash. However, the use of steroids in shingles is controversial. Your doctor will advise you. Steroids do not prevent PHN.
Year Five: Chronic Or Recurrent Eye Disease
When shingles impacts the eyes its called herpes zoster ophthalmicus, or HZO. And according to a report in the journal Ophthalmology, 25% of patients experience chronic or recurrent eye disease within five years of HZO. Although most patients with HZO do not experience recurrence, it is important for patients to remain vigilant for recurrences due to potential for long-term damage to their eyes, says Dr. Shekhawat. Recurrent HZO can cause severe dry eye, corneal nerve damage and inflammation and scarring on the inside of the eye, which can damage vision and cause elevation of intraocular pressure leading to glaucoma, says Dr. Shekhawat.
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Avoid Intense Or Irritating Movement
According to the American Academy of Family Physicians, shingles rashes most often appear on the trunk of the body, which includes your:
Shingles rashes can also occur on the:
With that in mind, its best to avoid activities that require you to lay on these areas, like exercising on the floor or a workout bench. For instance, if youre doing gentle yoga, skip any poses that have you lying in the prone or supine position, where your belly or back are touching the floor, respectively.
Additionally, intense cardiovascular exercise like running or cycling may irritate a shingles rash, especially in the early stages.
As you heal, consider switching to lower-intensity workouts like walking until the blisters dry up and crust over. According to the National Institute on Aging , this generally takes around 7 to 10 days after a rash appears.
If possible, hold off on high intensity exercise until the scabs are completely cleared up, which may take 2 to 5 weeks.
Ethics Approval And Consent To Participate
We identified this patient during routine clinical practice and consented to give venous blood samples after elaborate information. Written informed consent was obtained from the patients parents for publication of this case report and the accompanying images. A copy of the written consent is available for review. Involvement of the ethical committee of the Huashan Hospital of Fudan University was considered unnecessary, since the project was not based on a study protocol.
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When To Seek Medical Advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
Coping With Shingles Pain
If you have shingles, you may be wondering how to cope with the pain:
- Be sure to get plenty of sleep and eat a healthy diet to help boost your immune system.
- Wear comfortable, loose clothing with natural fiber .
- Establish or maintain a regular exercise routine.
- Utilize home remedies to help soothe pain from blisters.
- Engage in activities that help take your mind off of the pain.
- Establish a routine to help manage stress.
- Seek out support when needed from family and friends as well as professional supportive services.
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A Word About The Shingles Vaccine
If you are age 60 or over and have not had shingles, talk to your doctor about getting the shingles vaccine. Not only will it reduce your risk of developing shingles, but if you do develop shingles, youll be more likely to have a mild case. And, just as important, youll be much less likely to develop PHN if youve had the vaccine.
Month Two To Three: Lingering Itch
The lasting itch one can experience once the shingles rash clears is called postherpetic itch and it most commonly develops on the face and on skin thats already suffered sensory loss. Translations: Your skin is likely already feeling numb there. And since individuals are more likely to scratch numb skin too long and too vigorously, its important to turn to your healthcare provider for advice. He or she will likely suggest topical local anesthetics to help quell the urge to itch.
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Shingles And Your Eyes
If the shingles rash breaks out on the face, near the eye, the vision may be affected. An ophthalmologist should be consulted right away when pain or other symptoms of shingles affect the eye or the area near the eye.
Shingles painand other symptoms from an outbreak of herpes zosterusually lasts between three to five weeks. Most people experience shingles once, but in some instances, people will continue to experience pain. When this happens, its called postherpetic neuralgia .
Can Shingles Be Prevented
There are 2 vaccines available to reduce the likelihood of developing shingles, Zostavax and Shingrix. If you are over 50, you can talk to your doctor about whether you need it. It is recommended for everyone over 60 and is given free of charge in Australia to people aged 70 to 79.
Vaccination will not guarantee that you will not get shingles, but it will reduce your chance of developing the condition. The vaccine used to protect against shingles is not the same as the vaccine used to protect against chickenpox. Read more about the chickenpox vaccine here.
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Shingles On Stomach But Pain In Other Areas
I’m a 28 year old male in good health and was diagnosed with shingles 5 days ago after weird pain in my right side and first glance of a tiny rash. I immediately went to the doctor and got a 10 day prescription of Valtrex. Over the past few days the rash spread a bit from my stomach to back staying in a general stripe. Yesterday I started experiencing the same extreme sensitivity/pain in my right thigh and also in my right bicep/underarm. I don’t see any signs of a rash in those areas. I’m wondering if this is normal or if the shingles is spreading? Has anyone experienced this before? Thanks!
2 likes, 15 replies
Keys To The Diagnosis
There are several keys to the diagnosis of abdominal pseudohernia due to herpes zoster.
First, the physician should not rule it out simply because there is no rash. Although the condition is often termed postherpetic abdominal pseudohernia,, the bulging precedes the herpetic rash in nearly 10% of patients. This is why I prefer the term abdominal pseudohernia due to herpes zoster.
Second, a targeted history is important, eg, to rule out tick exposure and Borrelia-related neurologic complications.
Third, imaging tests including magnetic resonance imaging may be indicated to check for mechanical compression of thoracic nerve roots if close follow-up does not reveal delayed-onset herpetic rash.
The combination of unilateral bulging of the abdominal wall and herpetic rash indicates abdominal pseudohernia due to herpes zoster. The rash may develop after the bulging, and thus, close follow-up may be of benefit.
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When To See A Doctor
A person should see a doctor if they are experiencing any early symptoms of shingles, especially if they have a history of shingles or are at a higher risk of developing an acute outbreak of the virus due to any of the risk factors above.
A person undergoing treatment for shingles should follow up with a doctor if:
- the symptoms get significantly worse after treatment
- the symptoms do not go away within a few weeks
- new or different symptoms appear in addition to the rash
- there are signs of secondary infection, such as high fever, an open wound, or red streaks coming out of a shingles lesion
People should also speak to a doctor if they have lasting nerve pain in the affected region after the rash of shingles disappears. This complication, called postherpetic neuralgia, affects
In many cases , a doctor will prescribe an antiviral medication, such as famciclovir, valacyclovir, or acyclovir. Pain-relieving medicine can also help ease symptoms. Calamine lotion, colloidal oatmeal compresses and baths, and cold compresses may ease the itching of shingles.
It is important to refrain from scratching the affected area as this can irritate the blisters and increase the risk of infection.
Some people develop a superimposed bacterial skin infection over their shingles lesions. This infection can be very painful, and it may spread if a person does not receive treatment. Individuals who develop this infection in addition to shingles may require antibiotic treatment or even hospitalization.
Shingles And The Battle Of The Bulge
I thought I knew herpes zoster inside and out from patients experiences, my late mothers herpes zoster ophthalmicus , to my recent vaccination with Shingrix. I just became cognizant of a new complication of HZ the post-herpetic abdominal pseudohernia .
Following primary varicella infection, the varicella-zoster virus persists in spinal and cranial nerve ganglia. After reactivation and replication, the virus traverses through sensory nerve fibers associated with the involved ganglion resulting in its classical dermatomal vesicular eruption.
Neurologic complications of HZ are legion, with post-herpetic neuralgia being the most common. Meningoencephalitis, myelitis, cerebrovascular accidents due to cerebral vasculopathy, paresis, and paralysis are potential complications. The Ramsay-Hunt syndrome is defined as HZ oticus associated with peripheral facial nerve paresis other cranial nerves may also be affected. The involvement of the geniculate ganglion in RHS leads to a multiplicity of combination of sensory abnormalities , motor problems , or disturbances of lacrimal and nasal secretion.
Motor complications of HZ are infrequent, affecting 1-5% of cases. Development of mononeuropathies other than facial nerve palsy are rare.
The differential diagnosis of abdominal bulges includes a hernia or tumor , all of which may be detected by imaging. Pseudohernias should also be considered.
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How Is Internal Shingles Treated
There have been few trial studies that have examined internal shingles or the best treatments for this particular type of shingles. Thats why there are currently no guidelines for treatment. Instead, doctors rely on standard treatment for classic shingles.
Even though shingles is a virus, this is a case where there are antiviral medications available by prescription. Thats why its important to see a doctor right away if you suspect you have shingles. Early treatment may reduce the risk of complications, like PHN. Serious complications require hospitalization.
Common antiviral medications for shingles include:
Depending on the location and severity of shingles, steroids may also help. Anti-inflammatory medications like ibuprofen and pain-relieving medication such as acetaminophen or other prescription pain medication can help in easing pain experienced from shingles.
People whove had multiple bouts with internal shingles may be
estimated 1 in 3 people in the United States throughout their lifetime, according to the CDC. In certain cases, the virus can cause more severe infections, inflammation, or complications.
Its unclear how many people experience internal shingles, but its a rare condition. However, depending on the organ system affected, it can be life threatening.
They can provide a series of effective ways to manage symptoms and treat the virus. They can also check you to make sure you dont have a more serious complication.
This vaccine is over
Tingling Sensations Or Numbness
In addition to their flu-like symptoms, many shingles patients report tingling or numbness just before the shingles rash develops. These sensations typically occur in the same area of the body that the shingles rash later affects.
Not only that, but these sensations can also result in extreme sensitivity to touch. Patients often also report itching and burning. It’s believed that these sensations are the result of the shingles virus affecting nerve roots, which in turn respond to any stimulation, even on a microscopic level. For patients, it can seem like they’re experiencing burning or tingling for no reason at all.
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Preventing The Virus Spreading
If you have the shingles rash, do not share towels or flannels, go swimming, or play contact sports. This will help prevent the virus being passed on to someone who has not had chickenpox.
You should also avoid work or school if your rash is weeping and cannot be covered.
Chickenpox can be particularly dangerous for certain groups of people. If you have shingles, avoid:
- women who are pregnant and have not had chickenpox before as they could catch it from you, which may harm their unborn baby
- people who have a weak immune system, such as someone with HIV or AIDS
- babies less than one month old, unless it is your own baby, in which case your baby should have antibodies to protect them from the virus
Once your blisters have dried and scabbed over, you are no longer contagious and will not need to avoid anyone.