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Glucosamine therapy for the treatment of osteoarthritis

glucosamine therapy for the treatment of osteoarthritis
To answer this question, the scientists found and analyzed 20 research studies. The studies evaluated more than 2,500 people with osteoarthritis of the knee or hip. Most studies lasted two to three months. People received glucosamine (in tablets or injection) or were part of another group receiving a pill or a fake injection or a nonsteroidal anti-inflammatory drug (NSAID) to assess which was more effective. This Cochrane Review offers the best evidence that exists today.



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What is osteoarthritis and glucosamine?
Osteoarthritis (OA) is one of the most common forms of arthritis and can affect the hands, hips, shoulders and knees. In OA, the cartilage that protects the end of the bones is broken, causing pain and inflammation. Pharmacological and non-pharmacological treatments are used to relieve pain and inflammation. Glucosamine can be found naturally in the body and is one of the fundamental substances of cartilage. It is believed that glucosamine supplementation decreases destruction and increases cartilage synthesis and reduces inflammation. But there is a discussion about its effects.


How well does glucosamine work?
Pain: High-quality studies showed that the pain improved to the same extent when people received glucosamine or fake tablets. If all studies are analyzed (including low-quality studies and previous studies), then glucosamine improves pain to a greater extent than fake tablets.
The pain improved 13 more points on a scale of 0 to 100 with glucosamine than with the fake tablets.


Function: High-quality studies showed that glucosamine improved pain to a greater extent than fake tablets when measured by one type of scale, but improved to the same extent as fake tablets when measured with another scale. This result is the same when all the studies are analyzed (including the low quality studies and the previous ones).

Studies evaluating only the Rotta brand of glucosamine (including low-quality and previous studies) showed that glucosamine improved pain to a greater extent than fake tablets. Glucosamine improved function to a greater extent than fake tablets when measured by one type of scale but improved to the same extent as fake tablets when measured by another type of scale.

What security do you have?
The number of people who received glucosamine and had side effects was almost equal to the number of people who received fake tablets. Side effects included mainly upset stomach and other joint pains.


What conclusion can be established?
In a previous Cochrane review it was shown that glucosamine administered for six weeks reduces pain and improves function (physical capacity) in people with osteoarthritis.


Compared to the previous review, this review that analyzes the newer studies and more high-quality studies shows that there is "platinum" level evidence that pain does not improve greatly when glucosamine is administered for two to three months . According to the scale used to measure the function (physical capacity), the function may not improve completely or to a large extent.

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Glucosamine and chondroitin sulfate

The information contained on this page should not replace the recommendations and indications provided by your doctor. Glucosamine and chondroitin are nutritional supplements and as such are not subject to the same strict regulations required for over-the-counter and nonprescription drugs. Therefore, if you decide to take any supplement, you will do so on your own. Check with your doctor before trying these supplements. Make sure that the cause of the pain is osteoarthritis . Do not interrupt or reduce the dose of prescription medications you are currently taking until you see the doctor.



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What are glucosamine and chondroitin sulfate?

    This supplement may contain glucosamine in the form of N-acetyl glucosamine or sulfate salts or hydrochloride, and chondroitin as chondroitin sulfate. Both are substances that occur naturally in the body, present in the cartilage and that help to maintain their elasticity, lubricating the joints.

Glucosamine:

•     Glucosamine is an aminosaccharide that plays an important role in the formation and repair of cartilage.
•     Glucosamine, as a supplement, is extracted from crustaceans (such as lobsters, shrimp or crabs).

Chondroitin sulfate:

•     Chondroitin sulfate is part of a large protein molecule (proteoglycan) that provides elasticity to cartilage.
•     Chondroitin sulfate is extracted, in most cases, from the cartilage of the cattle trachea, but in Japan it is also extracted from shark cartilage. Like glucosamine, it can be synthesized in the laboratory.

What are these supplements used for?

•     These supplements have been used to treat osteoarthritis (OA) in horses and dogs for many years.
•     In Europe, glucosamine and chondroitin sulfate have been used to treat OA in humans since 1980.
•     It is important to remember that these supplements have not been well studied as treatment for other forms of arthritis or associated diseases, such as rheumatoid arthritis (RA) or gout , or to treat other causes of pain, such as stress fractures.

What studies have been done?

•     A small study conducted in 2012 showed improvement in symptoms when using glucosamine together with an NSAID, and a minor, but significant relief with glucosamine alone.
•     In 2015, a couple of studies were conducted on the use of glucosamine and chondroitin for the management of knee pain associated with OA. In the first, the effectiveness and safety of the supplement was compared with that of celecoxib (medicine marketed as Celebrex ). It was found that the supplement in question showed comparable efficacy to the drug in reducing pain, stiffness, functional limitations and joint inflammation after prolonged use for six months. (ARD Online First, Jan 14, 2015. Ann Rheum Dis doi: 10.1136 / annrheumdis-2014-206792 )
•     The most recent study, published in March 2015, which also analyzed the effectiveness of the supplement in patients with knee OA , gave less encouraging results. According to the researchers, the supplement was not shown to significantly relieve symptoms or modify the progression of OA. ( Effects of Glucosamine and Chondroitin Supplementation on Knee Osteoarthritis, Arthritis and Rheumatology, March 2015 ).

What do these supplements do?

•     In studies conducted mainly in Europe, some people with mild to moderate OA who took glucosamine or chondroitin sulfate showed some relief of pain and a better functioning of the joint. However, the research findings in the US are not consistent, since contradictory results have been observed.

What characteristics should the supplement have?

•     Glucosamine comes in various forms, the most common being glucosamine sulfate and glucosamine hydrochloride. Although both have the same efficacy, most studies used the sulfate salt.
•     Shark cartilage products contain chondroitin sulfate, but the quantity and quality of it is not consistent.
•     Since dietary supplements are not strictly regulated, the quality and content can vary widely.

Some suggestions for choosing quality products are:

•     Select a product manufactured by a large and respectable company that can take responsibility.
•     Read the labels of the products carefully to make sure that the list of ingredients makes sense.
•     Ask for recommendations to your doctor or pharmacist.
•     If you are allergic to shellfish or have an excellent diet of animal products, look for vegetarian / vegan formulas.

How are these supplements taken?

•     If you decide to try these supplements, experts recommend taking the amount used in most clinical studies:
•         Glucosamine: capsules, tablets, liquid or powder, 1,500 mg (milligrams) per day.
•         Chondroitin: capsules, tablets and powder, 800 to 1,200 mg per day divided into two to four doses.
•     If this dose relieves the symptoms, you can decrease the amount gradually after the first few months.
•     It may take a month before you notice any improvement.
•     It is generally recommended to ingest glucosamine and chondroitin sulfate together, although it is not known for sure if the combination has a better effect than the individual use of each substance.
•     You should plan your intake of the supplements along with the medications you currently take for 6 to 8 weeks. If the pain goes down, ask your doctor if you should decrease or stop the other medications for a period of time, to check if any changes in pain and stiffness levels are made.
•     If after four to six months you do not notice any change in symptoms, the supplements probably will not provide any relief. Some people may experience partial relief using the supplements, but they may need to continue taking medications for complete relief.

Do these supplements have side effects?

    Both glucosamine and chondroitin sulfate can have the following adverse effects:

•         Increase in intestinal gas
•         Stomach ache
•         Softer stools

    More studies should be done to confirm the safety and efficacy of the supplements. See your doctor if you notice any new or unusual symptoms when taking these supplements.

Precautions

    Children, pregnant women and women who may become pregnant should not take these supplements. These substances were not studied enough to determine the effects they could have on a developing fetus or a child.

People who have the conditions listed below should be cautious with these supplements:

Glucosamine:

•     Diabetes, since glucosamine is an aminosugar, dietetics must control blood sugar levels more frequently when taking these supplements.
•     Individuals on anticoagulants such as warfarin ( Coumadin ) in combination with glucosamine hydrochloride with or without chondroitin should refrain from taking the supplement.
•     Allergy to seafood, if you are allergic, consult your doctor before you start taking glucosamine. In most cases, allergies are caused by the proteins found in seafood, not by chitin, the carbohydrate from which glucosamine is extracted.
•     Glaucoma, a new study suggests that people with this disorder or with intraocular hypertension may worsen eye pressure if they take glucosamine. Other side effects are increased triglycerides and cholesterol.

Chondroitin sulfate:

•     This supplement may include components with structure similar to heparin, an anticoagulant drug, so ingesting it together with an NSAID, such as aspirin, could increase the risk of bleeding. In this case it is advisable to take the prothrombin time and coagulation more frequently.
•     Certain tablets may contain high levels of manganese (Mn), which could cause long-term nervous system poisoning (if it exceeds 11 mg Mn / day). In addition, since chondroitin comes from cattle, there is the remote possibility of contamination associated with mad cow disease.
•     If you are allergic to sulfonamides, avoid it, or start with small doses of chondroitin and be alert for side effects. Other effects are diarrhea or constipation.

Considerations:

•     The American College of Rheumatology, in its most recent recommendations for the initial treatment of OA (2012) does not recommend glucosamine or chondroitin to patients with osteoarthritis. Glucosamine and chondroitin alone or together do not always work for everyone. However, those who decide to try these supplements and benefit from them do not have to suspend them. Taking them for the long term seems to be safe.
•     Note that studies of the supplement have been done in patients with knee pain associated with OA, so it can not assume the validity of its use in other joints of the body or for other types of arthritis.
•     Discrepancies in the effectiveness of chondroitin can also be generated from variations in the doses and quality of the supplements. The content of chondroitin tends to vary quite a lot between different brands. The same can be said about glucosamine supplements. Talk to your doctor or pharmacist about which brand to choose from any of these products, or combination thereof.

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Glucosamine and arthritis

    Clinically fundamental: As a short-term intervention, oral and intramuscular glucosamine is associated with pain relief and symptomatic in patients with arthritis. Glucosamine appears to be similar in efficacy to NSAIDs, but long-term interventions are needed to establish the efficacy and adverse effects.



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Glucosamine is a treatment that does not require a prescription and is available to relieve pain and symptoms related to arthritis.

Systematic review
Moore RA. Glucosamine and arthritis. Bandolier 46; 1998

    Outcome variables: pain, swelling, days elapsed until improvement, response to treatment

The inclusion criteria were controlled and randomized clinical trials of oral or intramuscular glucosamine as a treatment for arthritis; comparisons with placebo or active treatment. We summarized the findings of the original articles, and where possible, we calculated the relative benefits and numbers needed to treat with 95% confidence intervals using the response rates for the active and placebo groups on variables related to pain.

Findings
All included studies evaluated oral and / or intramuscular glucosamine in patients with arthritis for up to eight weeks. Six studies were double blind, and two were not masked. The studies included patients with osteoarthritis or gonarthrosis. Oral doses of glucosamine were 1.5 g / day, and intramuscular doses of 400 mg twice to three times a week.

Dichotomous data were obtained to calculate the relative benefits and numbers needed to treat. The types of variables that could be obtained varied between the studies, and included pain assessment, symptomatic relief, response to treatment. These variables were taken between 3 and 8 weeks
.
Placebo-controlled trials
Five trials demonstrated significant beneficial effects of glucosamine versus placebo. Three of them presented a significant relative benefit, and a global number needed to treat 5.0 (3.5 to 8.9) for short-term pain reduction benefits compared to placebo.

Controlled trials with active treatment

Three studies compared glucosamine with NSAIDs. Two trials compared 1.2 g / day of ibuprofen with oral glucosamine in 239 patients, and found no significant differences. The third study compared intramuscular glucosamine with intramuscular phenylbutazone, but did not show significant results.

Adverse effects
Few adverse effects or dropouts from these studies were found. They tended to occur less frequently in patients with glucosamine than in those in the NSAID group. A large non-masked study with 1208 patients taking oral glucosamine at a dose of 1.5 g / day for 13 to 99 days presented 28 patients who discontinued treatment due to adverse effects. The adverse effects that were found in more than 1% of the patients were epigastric pain / discomfort, heartburn, diarrhea, and nausea.

SANIFLO SANIACCESS 3 UPFLUSH MACERATOR PUMP + ROUND TOILET KIT, WHITE FINISH

Will rusty bolts in my toilet tank cause a leak?

The toilet tank in a toilet is like the engine of a car. The tank uses the water inside to feed the waste and other materials into the container below. The tanks are secured in the location on the back of the cup by means of tank bolts. Because these tank bolts are in such proximity to the water, they can sometimes oxidize and cause leaks.



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Hygienic operation

Toilets work by flushing a certain amount of water through the toilet bowl to carry the waste inside. Before the discharge, the water is carried out inside the toilet tank, which is located above the bowl. Pressing down the discharge handle opens a flap inside the tank, and the force of gravity makes the water through the opening of the fin and into the container. The holes drilled inside the bowl rim create a whirling movement, which helps to power the objects inside the bowl.

The placement of the tank

The toilet tank sits on top of the back of the cup. The reservoir is usually based on a series of ridges in the container that holds it firmly in place. A couple --- --- sometimes more than toilet tank bolts are inserted through the bottom of the tank and through the back of the bowl. Rubber washers on top of the bolts hold the bolts in place and also seal the bolt holes. Nuts and washers keep the bolts in place underneath.

Rusty screws

Over time, the rubber washers on the top of the screws may begin to decline. This is especially true if you use certain additives in the tank, such as deodorants or cleaning products, and leave the tank to sit for a period. As the water evaporates in the tanks, the level of concentration of chlorine in the tank strengthens, which works to dissolve the rubber. Once the rubber dissolves, the water in the tank will begin to oxidize the screws and work its output from the tank.

The repair of rusty screws

Rusted screws should be replaced as soon as possible to help prevent a leak before it starts. Before repairing the tank, empty first. Close the water supply to the wall under the tank and pull the chain. Release the tank supply hose. Use a wrench or pliers to remove the nuts from the rusted tank bolts. If you can not remove the nut with tools, cut the nuts on the end of the bolt with a hacksaw. Protect the tank while it is working by covering it with adhesive tape.

KOHLER K-4197-96 Wellworth Round-Front Bowl, Biscuit

There is leakage of water from the toilet tank to the floor

A leaking toilet tank can become a wet disaster. The toilet tank has water in the reserve to pull the chain. Water flows from the supply line on your wall in the tank. Over time, the screws and gasket that hold the filtration tank can perform or loosen. Tightening the screws or replacing the rubber gasket can solve your problem. If the leak is not fixed by these solutions, the tank may have a crack. In this case, the tank itself will have to be replaced.



KOHLER K-4197-96 Wellworth Round-Front Bowl, Biscuit

Instructions

1 Try to move the tank back and forth. If the tank jiggles, a simple tightening of the screws located on the bottom of the tank can solve the problem. After tightening the screws, pull the chain to check for leaks. If there is a leak they remain, replacing the board can fix the problem.

2 Close the water in the supply line from the wall by turning the stopcock to the right.

3 Pull the chain and hold the push button until all the water has drained from the toilet bowl.

4 Remove the supply line from the toilet tank with channel locking pliers by turning the toilet line connection bolt to the left. Place a towel under the line to collect the remaining water.

5 Loosen the nuts on each side of the bottom of the toilet tank. Carefully lift the tank out of the cup and put it on its side.

6 Remove the rubber gasket located at the bottom of the tank. Use a spatula or utility if the joint does not come off easily. Wipe toilet residue with a towel.

7 Apply a sealant to the reservoir around the opening. Fit the new rubber gasket over the opening; Be careful to align the board with the opening. Allow the joint sealant to dry for five to 10 minutes.

8 Set the tank back on the toilet. Tighten the screws located on the bottom of the tank.

9 Reconnect the toilet supply line and convert the water again by turning the valve counterclockwise.

10 Check for leaks. Wipe any remaining water from the floor with a towel.

Tips and warnings

•     Take the old board with you to the hardware store so you can buy the correct replacement size.

Kohler K-4067-NY Bancroft Comfort Height Elongated Bowl, Dune

How to seal a toilet tank

If the accumulation of water is observed on the back of the toilet bowl, check the coupling of the inlet tube on the bottom of the tank to ensure there are no leaks. Wrap a strip of toilet paper around the joint; If the paper peels dry, the rubber seal between the container and the container is damaged and must be replaced. Even though it takes some heavy work, replacing the rubber gasket is quite easy, as long as you have the correct spare parts.



Kohler K-4067-NY Bancroft Comfort Height Elongated Bowl, Dune

Instructions

1 Close the closing of the water supply valve to the toilet tank and pull the chain. Remove the lid from the reservoir and sponge out any remaining water in the bottom of the tank.

2 Undo the joint that connects the flexible hose of the shut-off valve to the base of the tank with an adjustable wrench. Lift the rubber washer into the joint with a fine screwdriver. If the washing machine is hard and brittle, unscrew the assembly from the other end of the compression and replace the entire hose at the same time as you have the opportunity.

3 Locate the two large slotted head screws on each side of the flap valve on the bottom of the tank. These screws connect the tank to the toilet bowl. Insert a large flat-blade screwdriver into one of the slots to prevent the screw from turning. Undo the nut on the bottom of the vessel flange with an adjustable wrench. Repeat this procedure and remove the second connection bolt.

4 Swing the toilet tank side to side to break the seal. Lift the container out of the container and place it face down on a thick towel next to the toilet. Take off the old rubber gasket from the socket. Scrape off any dirt that surrounds the outlet and the coupling flange on the toilet bowl with a spatula and a rag.

5 Take the old seal to the hardware store to make sure you buy the right size replacement. Also, purchase a new kit-tank to bolt cup, a flexible spare water supply pipe, and some silicone plumber's grease while you're there.

6 Coat both sides of the rubber-tank replacement to the cup seal with a thin layer of silicone grease plumber. Place the seal on the outlet of the tank with the upper conical part. Move the tank on the right side up. Place steel washers from the replacement kit on the new tank bolts to the bowl, followed by the fiber washers. Insert the screws through the holes in the bottom of the tank.

7 Lower the tank onto the cup. Make sure that the rubber-to-cup gasket fits perfectly in your recess-assignment dates, while slotting the bolts that fix into their respective holes in the flange bowl. Place fiber washers followed by steel washers through the bolts under the cup and thread the nuts until they are in hand tight; all washers are included in the bolt-to-cup replacement kit.

8 Place the head of a large screwdriver in the slots of the tank bolts from inside the tank to prevent them from turning. Tighten each nut alternately in half a turn with the adjustable wrench. Keep tightening each nut in turn to compress the rubber-tank washer to the cup. Do not over tighten the nuts when forcing the key after a firm resistance is felt.

9 Screw the fitting onto the end of the flexible water line on the compression stop valve. Tighten firmly with the adjustable wrench. Connect the end of the tank to the water supply line and tighten firmly with the adjustable wrench.

10 Pour a liter of water into the tank and check the connection bolts and rubber gasket for leaks. Tighten each bolt to connect another quarter turn if necessary. Open the shutoff valve of the water supply. Rinse and refill the tank two or three times to make sure there are no leaks during the washing action. Replace the toilet tank lid to complete the installation.

Tips and warnings

•     Wear latex gloves while working on a toilet.

Mansfield 135WHT 135010007 White Elong Toilet Bowl

How to connect a toilet tank to a Bowl

Installing a new toilet or replacing a larger toilet is not difficult. Be careful when handling the toilet bowl and the toilet tank. Porcelain is relatively easy to chip during handling. A maintenance staff do it yourself can install the toilet tank over the toilet bowl in a few minutes and without much difficulty.



Mansfield 135WHT 135010007 White Elong Toilet Bowl

Instructions

1 Place the tank cushion washer over the toilet bowl.

2 Place the two thick rubber washers in the tank where the bolts pass through them to tighten the tank to the bowl.

3 Support the tank in the container carefully so that you do not splinter the porcelain. Align the two holes that the screws will go through by tightening the tank with the corresponding holes in the toilet bowl.

4 Place a washer on a bolt and slide it through one of the holes in the task. Repeat this step for the other side.

5 Place the other washer on the end of one of the bolt under the rim of the toilet bowl. Hand tighten the nuts on the bolts.

6 Place a 2-foot level on the top of the toilet tank to verify that it is level. Tighten the nuts and screws carefully with a flat-head screwdriver and an adjustable wrench. This compress the thick rubber washer between the tank and the container. They alternate between the two nuts and bolts while checking that the tank remains level.

Tips and warnings

•     Most toilets come with the assembly load value and the waste gasket is already fixed in the tank. If they are not, it is easier to install them before the tank joins the bowl.
•     Do not tighten the screws that hold the tank. This can break the toilet.

KOHLER K-4325-L-0 Kingston(TM) Wall-Mounted 1.6 or 1.28 GPF Flushometer Valve Toilet Bowl with Top Inlet and Bedpan Lugs, Without Seat, White White

What is the purpose of isolating a tank from the toilet?

Hygienic insulation kits provide a solution for sweat toilet cisterns, which occur in areas with high heat and humidity in the summer months. Sweating toilets can cause significant damage to a house, including the structure, causing water damage and allowing the formation of mold and deteriorate materials, including floor joists and drywall.



KOHLER K-4325-L-0 Kingston(TM) Wall-Mounted 1.6 or 1.28 GPF Flushometer Valve Toilet Bowl with Top Inlet and Bedpan Lugs, Without Seat, White White

The sweat tank of the toilet

A toilet tank usually contains cold water, which is in the tank until the handle of the toilet is pressed, the opening of the valve in the bottom of the toilet and letting the water out of the tank and into the tank. container. Then the waste is thrown down the drain. When the weather heats up and the humidity level rises, hot and humid air condenses when the toilet tank comes into contact. The condensation on the outside of the tank, or the drops of sweat, accumulate until they run out on the sides of the tank and fall on the floor below.

Water damage

A toilet tank will sweat a certain amount of water during a day, depending on the humidity levels inside the bathroom. As water drips on the bathroom floor, water collects or pools around the base of the toilet. This water can damage and discolor the finish of the bathroom floor. Water can also seep into the subfloor where it will damage the floor joists, cause mold growth and ruin the roof and lights below.

Isolation

Toilet tank isolation kits maintain a sweat toilet, providing a layer of insulation between the water in the tank and the walls of the tank. Trim the insulation pieces to fit along the different sides of the inside of the tank. The insulation keeps the walls of the tank from becoming so cold since the insulation keeps the cold water cooling down the walls of the tank. Adhesive that comes with the insulation kit keeps the insulation pieces from coming loose.

other changes

There are other solutions to a toilet tank sweating. You can place a cover on the outside of the toilet, which will help keep water running on the sides of the tank. The operation of a dehumidifier in the house will dry in the air, which will keep the condensation from accumulating in the toilet tank. An anti-sweat valve will introduce hot water into the water supply in the toilet. While the addition of an excess of hot water in the tank or container of a toilet will result in the formation of odorless cracks, an anti-odor valve will introduce enough so that the tank will not be cold enough that condensation will form. Some antisudor valves allow the user to adjust the amount of hot water in the tank or even shut off the hot water supply outside in cold weather.

Danze DC013230BC Orrington Elongated Toilet Bowl with Soft Close Seat, Biscuit (Bowl Only)

Can a toilet tank be occupied by a water supply by gravity?

One of the ways in which water is supplied through pipes for drinking, cooking and cleaning is through a system of gravity, which is an ancient system that has been in use since humanity began to take advantage of water. One of the many accessories that a gravity water supply can be connected to a toilet, which can use water by gravity to fill the toilet tank.



Danze DC013230BC Orrington Elongated Toilet Bowl with Soft Close Seat, Biscuit (Bowl Only)

Water supplies by gravity

gravity water systems, as the name implies, use the force of gravity to maintain water pressure along a pipe network instead of a pressurized water system that uses a pump or other hydraulic means to maintain the Water moving through the pipe network. Gravity water supply maintains a water reservoir stored higher than the pipe network to maintain this pressure. An example of this type of systems are the visible water towers on top of residential buildings and other structures.

Hygienic operation

Toilets pulled into the water from the pipe network through a plumbing fixture is called a toilet tank fill valve. A mobile float connected to the filling valve rises and falls on top of the water in the measuring tank that is filled. When the water reaches the proper level in the reservoir, the float signals the filling valve to shut off the water supply. After the tank is emptied, the float sinks again, indicating the fill valve to open and refill the tank.

Tap water for the toilet

Gravity water supply pipes connect to the bathroom by running through any floors or intermediate walls. If feeding through a wall, notches are cut into the wall studs so that the pipes sit inside the wall space, and drywall can be placed on top of the wall studs uniformly. In some countries, water pipes to the toilet bowl run along the outside of the walls.

Connecting the Gravity supply pipe

Crown the end of the water supply line by gravity with a water supply valve, which will allow you to cut the water supply for the bathroom without having to interrupt the water supply for the rest of the house. Wrap the inlet on the bottom of the toilet fill valve with plumber's tape, and do the same with the outlet of the water supply valve. Connect a flexible tube between the two by screwing the couplings into the inlet and the thread outlet.

KOHLER K-4309-96 Cimarron Comfort Height Elongated Toilet Bowl with Class Five Flushing Technology, Biscuit

The addition of water to the back of a toilet tank

The back of a toilet consists of a tank that contains the water that is used when flushing the toilet. The water drains from the tank to the bowl when the chain is pulled, pushing the water from the bowl and the contents down the drain. If the water level of the tank is too low or if you need more water to add pressure to push down contents of the cup that are not easily flushing, you can add water to yourself. This is not a permanent solution for a toilet that eliminates incorrectly or is always running.



KOHLER K-4309-96 Cimarron Comfort Height Elongated Toilet Bowl with Class Five Flushing Technology, Biscuit

Instructions

1 Remove the top cover of the toilet tank. Consider the water level in the tank.

2 Pull the chain while looking inside the toilet tank. Write down where the water level stops. Observe the inside wall of the toilet tank for a watermark or a fading line.

3 Locate the water overflow tube in the tank - a small tube on the top of the tank that deflects the water when the level is too high.

4 Slowly pour the water into the toilet tank until it reaches the level of water discoloration or until it is about one inch below the opening of the overflow tube.

5 Rinse the bathroom to clean the toilet bowl and inspect the level of water that rises in the tank. Add more water if necessary.

Tips and warnings

•     If the water level is consistently low, this may indicate a problem with the toilet itself. If the arm of the float in the tank is not rising or falling, you may need a replacement. If the water runs constantly, it means that the seal flap locking the hole in the bottom of the tank is loose or misaligned. It can also mean that the float arm is perfectly aligned or broken and must be replaced.
•     Do not overfill the toilet tank as this could cause overflow.
•     Use a plunger to unclog a clogged toilet before using the water tank filling method.

Gerber Plumbing 21-372 Gerber Ultra Flush Watersense Elongated Toilet Bowl Only, White

Toilet tank settings

Although the exterior design of the bathrooms vary, the vast majority of the bathrooms have a fairly basic tank design. When the handle of the toilet is depressed, a chain attached to a ball at the bottom of the toilet tank rises and allows the water inside the tank to enter the toilet bowl. As the water refills the tank, the level is controlled by a float valve, which then converts the water to the specified level. The vast majority of tank problems can be traced back to one or more of these components, and usually the problem can be solved only with a small adjustment.



Gerber Plumbing 21-372 Gerber Ultra Flush Watersense Elongated Toilet Bowl Only, White

Adjustment of the elevator or chain cable

The bathrooms have either a chain or a cable that connects the handle to the rubber ball or the flap located on the bottom of the tank. If the toilet does not discharge or will not completely eliminate, probably the chain has stretched or the cable has to be straightened. The chain length is adjusted by replacing the chain with one of a different length. Change the chain with one that allows approximately 1/2 inch of slack. Unhook each end of the old chain from the rubber or hinge ball and link the handle to remove it, then connect the ends of the new chain to the components. If the toilet has a wire instead of a chain, straighten the wire by bending it.

Handle adjustment

If the handle of the toilet is difficult to push or sticks when depressed, the handle probably needs to be cleaned and adjusted. Note that a nut secures the back of the handle to the inside of the tank. Turn the nut clockwise with a wrench to remove it. Do not turn the nut in the opposite direction, as the threads are reversed. Rub the nut and the back of the handle with a brush soaked in vinegar to remove any build-up of lime. Turn the nut counterclockwise on the back of the handle to tighten the nut on the handle. Tighten the nut only until the nut is tight, or else the handle will be difficult to depress.

Adjusting the water level in the tank

If the toilet runs continuously, it is very likely that the water level inside the tank needs to be lifted. The water level is determined by the rubber ball or float inside the tank called a "float valve." Most ballcocks are suspended inside the tank by means of a metal arm. Bend the arm to lift the float valve. Other float designs have a metal rod attached to the side of the float valve with a clip. Slide the clip up along the length of the bar to adjust the height of the float valve. Finally, some bathrooms have a float valve without a float mounted on the bottom of the tank. Note that a single screw is located on the back of the float valve. This screw adjusts the water level. Turn the screw clockwise, 1/2 turn at a time, with a screwdriver to raise the water level.

Adjustment of the discharge valve ball

The discharge valve is the opening in the bottom of the tank that tank water flows through when the toilet handle is stepped on. Pressing the handle causes a rubber ball on the bottom of the cable or the lifting chain to rise out of the discharge valve and allow water to drain out of the tank. If the tank is run continuously after adjusting the water level, this ball may need to be adjusted, as it is likely not to seal against the discharge valve. Note that the ball is suspended by a metal guide arm on the discharge valve. The guide arm has a single adjustment screw. Loosen the screw with a screwdriver and move the guide arm until the balloon is placed directly on the discharge valve and the bottom of the ball rests inside the opening of the relief valve, then tighten the arm screw guide.