Bath Rog (बाथ रोग): What It Is, Types, Symptoms and Treatment in Nepal

Bath rog (बाथ रोग) is the everyday Nepali name for a whole family of diseases that cause pain, swelling and stiffness in the joints, muscles and bones. It is not one illness with one cure: osteoarthritis, rheumatoid arthritis, gout, lupus and ankylosing spondylitis are all called bath rog in ordinary speech, and each one is treated differently. The doctor who specialises in these conditions is a rheumatologist, or बाथरोग विशेषज्ञ.

What does "bath rog" actually mean?

In medical English the same group is called rheumatic disease or arthritis: pain, swelling and stiffness in one or more joints. Because many different diseases cause that, the word alone does not tell you what is wrong or what will help. Putting a specific name to the disease is the main job of the first visit.

The main types of bath rog

Osteoarthritis (ओस्टियोआर्थराइटिस)

A degenerative joint disease in which the tissues inside the joint break down over time. It most often affects the knees, hips, hands, neck and lower back, and becomes more common with age. Pain comes on with use and settles with rest, and stiffness in the morning or after resting usually lasts less than 30 minutes.

Rheumatoid arthritis (रुमाटोइड आर्थराइटिस)

An autoimmune disease: the immune system attacks the lining of the person's own joints. It usually begins in the small joints of the hands and feet, often on both sides at once, and morning stiffness lasts longer than half an hour. It can also bring tiredness, fever and weight loss, and affect the eyes, lungs and heart. Women are affected two to three times more often than men. More in our guide to rheumatoid arthritis.

Gout (गाउट)

Urate builds up over a long period and forms needle-shaped crystals in and around a joint. The pain arrives suddenly and is severe, usually in the big toe, though ankles, knees, hands, wrists and elbows can also be hit. It is more common in men and usually develops in middle age. See our guide to gout and high uric acid, including what the evidence says about daal.

Lupus (लुपस)

A long-lasting autoimmune disease that can affect many parts of the body: skin, joints, heart, lungs, kidneys, blood cells and brain. Symptoms vary between people, from mild to severe. Women get lupus about nine times more often than men, usually between the ages of 15 and 45.

Ankylosing spondylitis (एन्काइलोजिङ स्पोन्डिलाइटिस)

A type of arthritis that inflames the joints and ligaments of the spine. The usual symptom is lower back or hip pain with stiffness, and it tends to first develop in teenagers and young adults; most people develop symptoms before the age of 45. Persistent back pain in a young adult should be shown to a doctor, not treated as an ordinary strain.

How bath rog is diagnosed

For most of these diseases there is no single test, and the pattern matters more than how bad the pain feels. A rheumatologist takes a medical history, examines the joints and watches how you move, then orders laboratory tests and imaging. Which joints are involved, whether both sides hurt, how long morning stiffness lasts and whether there are symptoms away from the joints all point in different directions. Blood tests used in rheumatoid arthritis include rheumatoid factor (RF) and anti-CCP antibody. In gout, the most definite test is taking fluid from the swollen joint with a fine needle and looking for urate crystals under a microscope. Ultrasound and MRI can pick up changes early, when X-rays are still normal.

How bath rog is treated

Treatment depends on which disease it turns out to be, so what follows is what a doctor may consider, not a prescription. In osteoarthritis, care centres on pain control, exercise and joint protection. In rheumatoid arthritis, a doctor may prescribe disease-modifying antirheumatic drugs (DMARDs) and, if those are not enough, biologic medicines; the aim is remission. In gout, anti-inflammatory medicines settle an attack while urate-lowering medicines prevent the next one. Lupus is treated with medicines that calm the immune system.

Rheumatologist or orthopaedic surgeon: who treats bath rog?

If you see an orthopaedic surgeon first for an injury or a fracture, that is the right choice. The American College of Rheumatology draws the line this way: an orthopaedic surgeon's role is to perform surgery on bones and joints, while a rheumatologist's role is to work out which musculoskeletal disease a person has and treat it without surgery. If no injury lies behind the pain, if it has lasted weeks, if several joints are involved, or if it comes with rash, fever or fatigue, a rheumatologist is the right starting point.

बाथ रोग: नेपालीमा संक्षेप

बाथ रोग भनेको जोर्नी, मांसपेशी र हड्डीका धेरै किसिमका रोगहरूलाई जनाउने सामान्य नेपाली शब्द हो। यसका मुख्य प्रकारहरूमा ओस्टियोआर्थराइटिस, रुमाटोइड आर्थराइटिस, गाउट, लुपस र एन्काइलोजिङ स्पोन्डिलाइटिस पर्छन्। हरेक प्रकारको उपचार फरक हुने भएकाले सही रोग पहिचान गर्नु जरुरी छ। जोर्नी दुख्ने वा सुन्निने समस्या लामो समयदेखि छ भने बाथरोग विशेषज्ञ (रुमाटोलोजिस्ट) लाई देखाउनुहोस्।

When to see a rheumatologist

Consider an appointment if joint pain or swelling has not settled, if morning stiffness lasts more than 30 minutes, if the same joints hurt on both sides, if back pain and stiffness began before the age of 45 and have run for months, if a joint suddenly became red, hot and severely painful, or if joint pain comes with rash, fever, mouth sores, hair loss or weight loss. In rheumatoid arthritis, early diagnosis and management can reduce symptoms, slow the disease and prevent disability, so waiting carries a real cost.

Rheumatology care in Kathmandu Valley

Rheumatology care at Tulsi Multi Speciality Clinic is provided by Dr. Krishna Adhikari, consultant rheumatologist and Lecturer in Internal Medicine at Patan Academy of Health Sciences (Patan Hospital), NMC No. 13049. He consults Sunday to Friday from 4:00 PM at AVM Chowk, Manbhawan, Lalitpur-5, Kathmandu Valley. See our rheumatology service and Dr. Adhikari's profile, book an appointment, or call +977-1-5914294. This article is general information, not a substitute for a consultation.

Sources

• American College of Rheumatology — What is a Rheumatologist?
• NHS — Arthritis
• NHS — Osteoarthritis
• NIAMS — Osteoarthritis
• NIAMS — Osteoarthritis: Diagnosis, Treatment, and Steps to Take
• NIAMS — Rheumatoid Arthritis
• NIAMS — Rheumatoid Arthritis: Diagnosis, Treatment, and Steps to Take
• NHS — Rheumatoid arthritis: Symptoms
• World Health Organization — Rheumatoid arthritis
• NIAMS — Gout
• NIAMS — Lupus
• NIAMS — Ankylosing Spondylitis
• NHS — Ankylosing spondylitis