Gallstones

Gallstones are small stones, usually made of cholesterol, that form in the gallbladder. In most cases they don’t cause any symptoms and don’t need to be treated.

However, if a gallstone becomes trapped in a duct (opening) inside the gallbladder it can trigger a sudden intense abdominal pain that usually lasts between one and five hours. This type of abdominal pain is known as biliary colic.

Some people with gallstones can also develop complications, such as inflammation of the gallbladder (cholecystitis), which can cause:

  • persistent pain
  • jaundice
  • a fever

 

When gallstones cause symptoms or complications, it is known as gallstone disease or cholelithiasis.

 

 

gall

The gallbladder

The gallbladder is a small, pouch-like organ found underneath the liver. Its main purpose is to store and concentrate bile.

Bile is a liquid produced by the liver to help digest fats. It’s passed from the liver through a series of channels, known as bile ducts, into the gallbladder.

The bile is stored in the gallbladder and over time it becomes more concentrated, which makes it better at digesting fats. The gallbladder releases bile into the digestive system when it’s needed.

Causes of gallstones

Gallstones are thought to be caused by an imbalance in the chemical make-up of bile inside the gallbladder. Bile is a liquid produced by the liver to aid digestion.

It’s still unclear exactly what leads to this imbalance, but gallstones can form if:

  • there are unusually high levels of cholesterol inside the gallbladder (about four in every five gallstones are made up of cholesterol)
  • there are unusually high levels of a waste product called bilirubin inside the gallbladder (about one in every five gallstones is made up of bilirubin)

These chemical imbalances cause tiny crystals to develop in the bile. These can gradually grow (often over many years) into solid stones that can be as small as a grain of sand or as large as a pebble.

Sometimes only one stone will form, but there are often several at the same time.

Gallstones are very common. You’re more at risk of developing gallstones if you’re:

  • overweight or obese
  • female, particularly if you’ve had children
  • 40 or over (the risk increases as you get older)

Treating gallstones

Treatment is usually only necessary if gallstones are causing:

  • symptoms – such as abdominal pain
  • complications – such as jaundice or  acute pancreatitis

In these cases, keyhole surgery to remove the gallbladder may be recommended. This procedure, known as a laparoscopic cholecystectomy, is relatively simple to perform and has a low risk of complications.

You can lead a perfectly normal life without a gallbladder. Your liver will still produce bile to digest food, but the bile will just drip continuously into the small intestine, rather than build up in the gallbladder.

Who’s at risk?

Gallstones are more common if you:

  • are female, particularly if you’ve had children, are taking the combined Pill, or are undergoing high-dose oestrogen therapy
  • are overweight or obese
  • are aged 40 years or older (the older you are, the more likely you are to develop gallstones)
  • have a condition that affects the flow of bile – such as cirrhosis (scarring of the liver), primary sclerosing cholangitis, or obstetric cholestasis
  • have Crohn’s disease or irritable bowel syndrome(IBS)
  • have a close family member who’s also had gallstones
  • have recently lost weight (from either dieting or weight-loss surgery)

Preventing gallstones

From the limited evidence available, changes to your diet and losing weight (if you’re overweight) may help prevent gallstones.

Diet

Because of the role cholesterol appears to play in the formation of gallstones, it is advisable to avoid eating too many fatty foods with high cholesterol content.

A healthy, balanced diet is recommended which includes plenty of fresh fruits, vegetables and whole grains.

There’s also evidence that regularly eating nuts, such as peanuts or cashews, can help reduce your risk of developing gallstones.

Losing weight

Being overweight, particularly being obese, increases the amount of cholesterol in your bile, which increases your risk of developing gallstones. You should control your weight by eating a healthy diet and regular exercise.

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High Blood Pressure

Hypertension or High Blood Pressure: The silent killer

Hypertension, or an abnormally high blood pressure, is almost as common as common cold in the present times. However, this abundance is not the worst manifestation of this medical condition. It is rather the fact that it comes and stays without prior warnings, which means there are no specific symptoms to signal its presence. It is a long term medical condition and one can be affected for years without having the knowledge of it.

The fact that it does not announce its presence with symptoms makes it difficult to identify and hence treat. Some people report headaches or dizziness but these can’t be considered as symptoms directly associated with high blood pressure.

There are two categories of Hypertension:

Primary or Essential, where the cause is mostly unknown and symptoms almost absent; and

Secondary, which suggests sustained stage of the same where it is accompanied by additional signs and symptoms. These additional symptoms are of medical conditions that coexist with hypertension, that are also deemed to be the cause of it. The prevalent cause of secondary hypertension is kidney diseases, but hyperthyroidism, hypothyroidism, Cushing syndrome and other endocrine conditions are also potential causes.

Although apparently harmless initially, a prolonged state of hypertension can be damaging in two ways— increased work load on the heart, and its effect on arteries. The increase work load on the heart causes the size of tissue of the cardiac muscles to expand. As the state of hypertension progresses, the heart becomes weaker. This wear and tear ultimately leads to a plethora of hypertensive heart diseases, coronary and peripheral artery diseases, stroke and chronic kidney diseases, causing multiple organ damage.

Like in most medical conditions, hypertension too should ideally be nabbed at the primary stage before it progresses to cause additional damage to the body. Experts advise regular health check-ups to keep track of the blood pressure, especially if you have a family history of hypertension behind you. Although mostly unknown, the following have been loosely considered causes of primary hypertension:

  • Aging
  • Genetics
  • Obesity
  • Lack of exercise
  • Stress
  • Depression
  • Maternal smoking and lack of breastfeeding in women

Nutrition and exercise: The role of well-balanced lifestyle in a condition of hypertension

At the primary stage, the few causes that can be kept in check are obesity, stress, depression and poor choice of lifestyle. The role of nutritional management in keeping a medical condition of hypertension, therefore, is paramount. A gradual weight loss in overweight obese individuals and maintenance of body weight slightly below normal levels is what one should aim for when targeting hypertension at the essential level. Expert-monitored diet plans that are crafted to individual need, coupled with regular aerobic physical activity, like brisk walking and light jogging are instrumental in maintaining a healthy lifestyle so as to check the onset of complications in a medical condition that arrives unannounced but leaves behind damaging consequences.

 

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Diabetes a Frighteningly Familiar Ailment

With over 67 million of the population of India alone being diagnosed with diabetes and around 66% Indian children having abnormal blood sugar levels, does Diabetes mellitus or Madhumeham, as called in India, like the common cold, now need to be christened the common diabetes? As far as this country is concerned, it is fast becoming the next big epidemic of our times.

Let’s take a look at how the disorder takes place: In normal functioning of the body, sugar taken in gets digested and broken down into its simpler form, glucose, which is carried by the blood to the cells where they get used up as fuel for energy. Insulin, a hormone produced by the pancreas, helps move the glucose into cells. A healthy pancreas adjusts the amount of insulin based on the level of glucose. When there is a break in this chain of process, it could result in any of the two types of diabetes:

Type 1: Where the body is completely unable to produce insulin

Type 2: Where the body produces insulin but the cells don’t respond to it

In both cases, the glucose can’t enter the cells, thereby increasing the level of sugar in the blood.

Symptoms of diabetes:

Out of all, the three big symptoms are the 3Ps:

Polydipsia: A state of unusually excessive thirst and a constant feeling of dryness in the mouth and throat.

Polyphagia: It is the medical term used to describe excessive hunger or increased appetite that is beyond response to strenuous physical activity.

Polyuria: A condition where the body urinates more than 3 liters a day, as compared to the normal one to two liters in adults.

However, the above symptoms are not always possible to detect, especially in Type 2 diabetes where symptoms appear gradually over a period of years. The other symptoms to take note of are:

Blurred vision: Blurred vision can affect one eye (unilateral blurred vision) or both (bilateral blurred vision) eyes, and can occur often or rarely, but most importantly, can lead to a more serious eye problem.

Slow healing of wounds: High blood sugar levels lower the immunity of the body which results in cuts and wounds taking unnaturally long to heal.

Unexplained weight loss: Barring the couple of kilos here and there that increase or decrease, body weight in adults is supposed to stay stable. Which is why any drastic weight loss (i.e. over 5% of your body weight) that is unintentional, should trigger alarms of an underlying ailment.

Fatigue or extreme tiredness: The type of weariness that doesn’t wear off even after adequate hours of rest.

Genital itchiness: Unless caused by skin irritations or allergen, in which case they reduce quickly, genital itchiness can be a sign of a more serious ailment like diabetes.

There are also some symptoms that are gender specific, for example:

In men

  • Reduced strength from loss of muscle mass
  • Thrush around the genitals
  • Itching of or around the penis
  • Erectile dysfunction

In women

  • Thrush and yeast infections
  • Itching around the vagina
  • Female sexual dysfunction

Before diabetes hits:

There are two stages where if detected, diabetes can be brought to control more easily:

Pre-diabetes: It means that the cells in your body are becoming resistant to insulin or your pancreas is not producing as much insulin as required. Your blood glucose levels are higher than normal, but not high enough to be called diabetes. It is a warning of a future development of diabetes but is also your chance of preventing development of Type 2 diabetes through proper diet and exercise.

Gestational diabetes: A form of diabetes that occurs during pregnancy, has the same symptoms as for other forms of diabetes. Sometimes the symptoms may not be noticeable, which is why women are tested for gestational diabetes between weeks 24 and 28 of their pregnancy. Gestational diabetes develops in about 3 to 5% of all pregnancies. It usually appears during the second trimester and disappears after the birth of the baby. If not controlled, complications can affect both the mother and the baby. GD also increases the risk of developing it again during future pregnancies and that of of Type 2 diabetes later in life.

Preventive measures against diabetes:

Reduce the intake of refined carbs like refined flour, white sugar, etc. and include more complex carbs like whole grains in your diet that take longer to digest, releasing slow but continuous energy for a long duration.

Get enough physical exercise in a day, either in the form of walking or running for a short while or playing a sport or a recreational activity involving physical movement. Just don’t sit stagnant for hours!

Get quality rest. Sleep for a good 6-8 hours and make sure it is deep sleep.

Keep stress out of your life. When in stress, the body releases a stress hormone called ‘cortisol’, which is antagonistic to insulin activity. The stress hormones make your blood sugar go up.

Have meals on time. Sure, work and business makes us put timely meals on a backseat, but at least starting the day with a hearty breakfast and ending it with a light, early dinner ensures that most of the damage has been controlled.

However, once diagnosed with diabetes, professional scrutiny and medication should be sought immediately to keep a check on further development.

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