Dear Doctor: We were shocked when our daughter, who is 26, was diagnosed with rheumatoid arthritis. I thought arthritis was something that elderly people got. What treatments are available, and what are our daughter's prospects for an active and healthy life?

Dear Reader: We're very sorry to hear about the medical challenge your family is facing and hope the information we offer will be of help.

When it comes to what is commonly referred to as "arthritis," we're actually talking about two different conditions. Osteoarthritis, which is the type of arthritis you're thinking of in regards to a more elderly population, is a degenerative disease. In osteoarthritis, the tissues of the joints deteriorate due to wear and tear. When the cartilage that cushions the joints begins to break down, it leads to swelling, stiffness and pain.

Rheumatoid arthritis, or RA, is an inflammatory autoimmune disease. Joint damage occurs because the immune system has gone haywire and begins to target the body's own tissues. Although RA most commonly affects the joints, it can also involve other parts of the body, including the lungs, digestive system, circulatory system, skin and eyes.

In the United States, about 1.5 million people (more women than men) are living with RA. It generally doesn't appear until the 40s, and becomes increasingly common as we hit our 50s and beyond, but cases in younger people are not rare.

The most common sites of inflammation in RA are the wrists and the finger joints closest to the palm. However, the knees, neck, ankles, feet, elbows and shoulders can also be involved. RA has a symmetrical pattern, so the joint on each side of the body is usually affected. In addition to that symmetry, symptoms of RA include tender and swollen joints, a feeling of warmth within the joints, fatigue and occasional fever. For many people, prolonged morning stiffness or difficulty moving again following a long period of inactivity can be some of the early signs of RA.

Treatment is tailored to each person's symptoms. Your daughter's rheumatologist will discuss lifestyle changes to address inflammation. This includes using special tools or aids to help with difficult tasks, pursuing the right kind of exercise -- hatha yoga has been found to be helpful -- and striking the optimal balance between activity and rest.

Eating a well-balanced anti-inflammatory diet can help manage RA symptoms. This treatment approach got a boost recently when a study found that RA patients who ate fish twice a week (baked, steamed, raw or broiled, but not fried) scored measurably lower on a standardized scale that measures disease activity.

Some medications for RA address pain and inflammation. Others take aim at the disease process itself. All have potential side effects, so urge your daughter to learn the risks and benefits of any proposed medication.

Looking to the future, advances in immunotherapy and the expanding study of the ever-surprising gut biome offer hope for RA sufferers. In the meantime, prompt treatment is crucial. Make sure your daughter finds a good rheumatologist she likes and begins her medical care.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: A recent news report said that diet sodas may be tied to stroke or dementia risk, but it didn't provide a possible cause. What's your take?

Dear Reader: You're referring to a 2017 study published in the journal Stroke. The study followed two groups of people: one over age 45 (2,888 people) and one over age 60 (1,484 people). The participants filled out food questionnaires three times: between 1991 and 1995, between 1995 and 1998, and between 1998 and 2001. Participants were asked about the type and frequency of their beverage intake. The groups of beverages included sugar-sweetened soft drinks, fruit juice, sugar-sweetened fruit drinks and artificially sweetened soft drinks. After the last questionnaire, researchers assessed the rates of stroke and dementia in the subsequent 10-year period.

People who drank artificially sweetened soft drinks one to six times per week had a 59 percent increased risk of stroke compared to those who did not drink artificially sweetened soft drinks. This rate increased to 79 percent among people who drank one or more of these drinks per day. The rate was even higher among people who reported this higher use most recently (between the years 1998 and 2001).

In regards to dementia, people who drank artificially sweetened soft drinks one to six times per week had a 30 percent increased risk of dementia compared to those who drank no artificially sweetened soft drinks, while people who drank one or more per day had a 70 percent increased risk.

These numbers seem significant, but the study's many confounding factors decrease their strength. For one, the number of people suffering strokes or developing dementia was limited, making it difficult to draw overarching conclusions.

Also, consider that -- according to the data -- people who drank sugar-sweetened soft drinks more than three times per week actually had a 20 percent reduction in the risk of strokes compared with those who drank none -- and a 23 percent decreased risk of dementia. My kids might disagree, but I really don't think that a greater number of sugar-sweetened soft drinks would be good for you.

Further, even before the study began, 22 percent of those who drank artificially sweetened sodas had diabetes, while 7 percent who didn't drink them had diabetes. Diabetes itself is a risk factor for both stroke and dementia, so the increased risk found in the study may have nothing to do with the sodas. The authors said they adjusted for this, but with such small numbers, that's difficult to do.

Don't get me wrong: Artificially sweetened sodas are certainly not healthy. They trick the brain and the body into believing it has had something sweet and thus may cause a greater overall craving for sweet foods or drinks. A 2012 evaluation of two large studies with 127,456 people found a 12 percent increased risk of stroke among people who drank one or more sugar drinks per day -- and a 9 percent increased risk of stroke among people who drank one or more artificially sweetened drinks per day. These results were more significant than the current study due to the large population of people involved.

So while there may be a link between diet sodas and stroke, it doesn't seem to be to the degree that this news report suggested.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: My son has started teething, and I'd like to ease his discomfort. I see that several homeopathic teething products have been recalled. Could they really be dangerous? If so, what are my options?

Dear Reader: It's six months into your baby's first year. Chances are, you've finally got a good parental rhythm going. Your sleep deficit is manageable, and your child is increasingly engaged in the world around him. Just as you're thinking that maybe you've got this parenting thing figured out, here come the joys of teething.

Babies enter the world with 20 primary teeth ready to emerge from their jawbones and through their gums. Six months is the average age at which that momentous first tooth makes its appearance, but it can happen anywhere between 3 and 12 months of age. And while plenty of babies breeze right through with minimal fuss, for others it's prime time for more than a little crankiness.

As the rough surface of the tooth advances, it can make the gums swell and ache. Some babies will drool freely, which can cause skin rash and irritations. And because Mother Nature apparently has a wry sense of humor, the process of tooth eruption -- that's when the tooth breaks through the gum -- tends to be more active at night. Say hello again to sleepless nights.

With multiple teething stages to deal with as lower and upper teeth, canines and molars emerge in the next two-plus years, parents want safe and effective ways to smooth (and soothe) this time of transition.

One remedy, available since the early 1900s, has been the herbal teething tablet. However, tests recently performed by the Food and Drug Administration on tablets by Hyland, a well-known maker of homeopathic products, revealed inconsistent amounts of belladonna, sometimes more than was listed on the label. Belladonna is an herbal ingredient with sedative effects that, in excessive quantities, can be toxic. Symptoms include lethargy, muscle weakness, constipation, excessive sleepiness, flushed skin, breathing difficulty and seizures.

The FDA asked Hyland to voluntarily recall its teething tablets and gels, which it did. The FDA has since also warned consumers that all homeopathic teething products may pose health risks for infants and children.

So how can you safely help your teething baby?

Although over-the-counter soothers like Orajel are an option, the American Academy of Pediatrics says that topical preparations wash away within minutes. For extreme discomfort, you may opt for an infant pain reliever. Always check with your pediatrician for proper dosage and duration of use.

After that, it's the age-old basics: pressure, massage, cold and cuddling.

-- Teething toys: Find an array of smooth, solid (not liquid-filled) toys for your baby to chew on. Rings are a nice option because they're easy for little hands to hold.

-- Massage: Use a clean finger and gentle pressure on baby's tender gums.

-- Ice: Freeze the toys for another element of pain relief. A wet washcloth, wrung out and then frozen, offers both cold and texture.

-- And don't forget the power of a soothing cuddle. Chances are that during the stress of teething time, the benefits will go both ways.

Do you have a great teething remedy to share? We'd love to hear from you!

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)