Methyl Alcohol Poisoning: Management Tips

Successful management of methyl alcohol poisoning requires prompt recognition. The most important therapeutic action is to correct the metabolic acidosis quickly. Methyl alcohol or methanol is an industrial solvent and widely used as paint thinner, paint remover, nail-polish remover and as a denaturant in ethyl alcohol. The poisoning due to methyl alcohol occurs due to consumption of rectified spirit or methylated spirit or illicit distilled ethyl alcohol. Methanol is completely absorbed within 3-4 hours of ingestion. After absorption the methanol is metabolized in the liver by the action of alcohol dehydrogenase to form formaldehyde and formic acid. Some of the ingested methanol is eliminated unchanged by the kidneys and lungs.

Ingestion of more than 30 ml of methanol/methyl alcohol is lethal, but the extent of toxicity may be influenced by concomitant ingestion of ethyl alcohol and other unknown host factors. A blood level of methanol of 20mg/dl is toxic. Severity of toxicity correlates with the level of methanol in blood. The variability in the development of methanol toxicity may be due to various liver diseases and availability and synthesis of alcohol dehydrogenase.

Symptoms of methanol poisoning after illicit alcohol consumption:

A person suspected of having consumed pure methanol or rectified spirit, industrial solvent/thinner, nail-polish remover or illicit distilled alcohol may complain of abdominal discomfort and pain, breathlessness, cardiac arrhythmia and blurred vision. If medical help is delayed the patient may go blind with delayed onset of coma.

Tips to manage methanol poisoning:

If the patient is not unconscious, try to know the type of alcoholic drink he/she has consumed. The patient should be shifted to emergency wing of a nearby hospital immediately. If the patient has consumed pure methanol, he/she should be encouraged to take around 4 oz of brandy or whisky to retard the metabolism as the enzyme alcohol dehydrogenase has more affinity for ethyl alcohol than the methyl alcohol. An assay of methanol blood levels can help to confirm the diagnosis, however, a patient having consumed a doubtful solvent and having metabolic acidosis and burred vision, should be considered a case of methanol poisoning and treated accordingly. Liver function tests along with blood pH and urine analysis should be done. The patient should be put on hemodialysis or promptly referred to a hospital where facilities for hemodialysis are available. Any arrhythmia, heart failure, convulsions or shock need urgent medical attention. If more than 4 hours have elapsed since ingestion and patient do not have arrhythmia and blurred vision, gastric lavage should be performed with sodium bicarbonate solution until the return fluid is clear of methanol. Patient should be kept under observation till considerable metabolic recovery.

Celiac Disease: Gluten-free diet is the treatment

The term allergy means hyper-action of our body's immune system to allergens (mostly proteins or compounds tagged to proteins). Like our skin and respiratory tract, our digestive tract (intestines) can also be hypersensitive to some constituents of food. Celiac disease is a disorder of the digestive system which is caused by intolerance/allergy to a protein called gluten. People with celiac disease can not tolerate gluten. The disease is partially genetic and inherited. Parents, siblings and children of people with celiac disease may also have/be having this disease. Celiac disease damages the inner lining of the small intestine and interferes with the absorption of nutrients from food. The cause of celiac disease is the immunological allergic reaction to gluten present in food that causes inflammation and damages the inner border (microvilli) of small intestine. Figure-1 below shows the ultrastructural changes at the inner lining of small intestine in a patient affected by Celiac disease. A visual comparison with Figure-2 (Normal inner surface of small intestine) would make you understand the pathological change.

Figure-1: Electron micrograph of biopsy from the small intestine of a patient affected by celiac disease showing eroded microvilli.

Figure-2: Electron micrograph showing normal microvilli at the inner surface of small intestine.

Sources of Gluten

Wheat, barley and rye are the main source of gluten. The gliaden component of gluten causes celiac disease. Some adhesives, medicines and vitamin products, which we use daily, may contain gluten.

Diagnostic symptoms of celiac disease

Some of the typical symptoms of celiac disease are failure to gain weight, diarrhoea, irritability, vomiting, abdominal pain and foul stools, early in infant life. The most common period of presentation and detection of celiac disease is between six months and two years of age. Some children may present with excessive appetite, abdominal distension, wasted muscle, finger clubbing and edema.

Preventive treatment of celiac disease

A gluten-free diet is the only treatment of celiac disease. A person aware of having intolerance to gluten should avoid eating foods containing wheat, barley and rye products. Modern drugs may provide symptomatic relief but ultimate treatment is preventive therapy in celiac disease.

Important Tips

1. Parents of the children with celiac disease have great responsibility to make the children comply with the doctor's instructions for gluten-free diet.


2. Recognizing and avoiding new food products containing wheat, barley or rye is a great challenge and people with celiac disease should be very careful since non-compliance of gluten-free diet may cause relapse.


3. People having celiac disease should take food items prepared from rice and corn only along with fruits, juices and milk products.


4. Reading the contents of grocery items is important before eating because many corn and rice products come from the manufacturers of wheat products.


5. Gluten-free but balanced diet is must for normal growth of the children affected by celiac disease.


6. Medicines coated/laced with gluten products should be avoided.

Management of Knee Pain

There are around 150 joints in our body and the Knee joint is most afflicted by disease or injury. The knee joint bears the brunt of our body weight and pain in this joint affects our mobility. Knee injury, immunological disorders, rheumatoid arthritis and gouty arthritis in addition to age related bone disorders may complicate the problem. Early management of pain and care of knee joints could be helpful to prevent any deformity and disability. Knee pain may be at front, back or at inner or outer side of knee joint. Our body weight exerts pressure on our knee joints during we walk, run or climb stairs. Pressure force on knee joint is almost 5 to 6 times more when we climb stairs as compared to when we walk on leveled ground or road. The size of our hips also affects pressure on our knee joints. Individuals with broader hips are at more risk to develop knee pain. Both the young and old people can be inflicted by knee pain but site of pain may vary person to person.

Tips to manage knee pain:

• Consult your family doctor or bone & joint expert for an early diagnosis.
• At home, early treatment involves wrapping with crepe bandage and elevation of knees to prevent swelling.
• Obesity is the major factor for the knee problem, so body weight control should be your first priority.
• Avoid climbing stairs and do non-impact exercise like walking or stationary cycling.
• Use sports shoes as these would help to reduce impact shock while walking.
• Warm oil or pain relieving liniment, spray or gel can be applied to knee joint and injured muscles.
• Try to keep your knees straight while sitting in a chair.
• Join rehabilitation exercise program to strengthen the muscles involved in injury and to regain power & coordination of the knee joint movement.
• Keep in touch with your physician for proper medication to avoid osteoarthritis.