Constipation

Constipation is irregular, infrequent or difficult passage of faeces. It is most often defined as having a bowel movement less than 3 times per week and often associated with hard stools or problems passing stools. People may suffer from pain while passing stools or may be unable to have a bowel movement after straining or pushing. It is the most common physiological disorder of the alimentary tract. It is characterized by incomplete evacuation of hard, dried stools. It occurs commonly in children, adolescents, adults on low fibre diets, patients confined to bed, in individuals and in elderly persons.

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Constipation is a common gastrointestinal problem, which causes many expenses for the community with an estimated prevalence of 1% to 80%, worldwide, where the condition is characterized by a wide geographical variation. Constipation is common during cancer treatment.

Types of Constipation

There are three main types of constipation:

Atonic constipation (lazy bowel): There is loss of muscle tone causing weak peristalsis due to lack of fluids, roughage and potassium, vitamin B Complex deficiency, irregular defecation habit and poor personelhygiene, excessive purgation or use of enema, sedentary lifestyle or lack of exercise.
Spastic constipation: It results from excessive tone of the colonic muscle.
Obstructive constipation: It occurs usually due to obstruction in the colon, cancer or any other obstruction due to inflammation or narrowing of the lumen.

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Causes of Constipation

. Constipation can occur with:

  1. Overuse of laxatives (stool softeners)
  2. Low-fiber diet
  3. Lack of physical activity
  4. Not drinking enough water
  5. Delay in going to the bathroom when you have the urge to move your bowels
  6. Stress and travel can also contribute to constipation or other changes in bowel habits.
  7. A change in regular routine or travelling
  8. Use of medications such as antacids with aluminum or calcium, antidepressants, antihistamines, narcotics (such as codeine), antispasmodics, diuretics, tranquilizers, some heart medications
  9. Use of supplements such as iron and calcium
  10. Health conditions such as irritable bowel syndrome, colorectal cancer, eating disorders, under-active thyroid, diabetes, Parkinson’s disease, multiple sclerosis, celiac disease, and depression

. Other causes of constipation may include:

  1. Colon cancer
  2. Diseases of the bowel, such as –  irritable bowel syndrome
  3. Mental health disorders
  4. Nervous system disorder.
  5. Pregnancy.

Possible complications

Possible complications from constipation include:

• Hemorrhoids
• Cracks or tears in the rectum
• Weakening of the muscles and ligaments that hold the rectum in place
• Blockage of stool in the large intestine
• Faecal impaction is defined as the retention of solid faeces that prevents spontaneous evacuation.

Faecal impaction is common in care homes and can lead to faecal incontinence. This is a costly consequence of untreated constipation. A related term is faecal loading, which describes the retention of faeces of any consistency.

Risk of constipation in Elderly people

For older adults in the community and in care settings, the risk of developing constipation may be increased by:

• Muscular weakness that limits general movement and the possibility of physical exercise as well as the ability to visit shops and carry shopping.
• Less mobile patients who experience a loss of sensation, or those who ignore the signal to empty their bowels to avoid inconveniencing a carer or because the toilets are inaccessible. In care settings, they may be offered a bed pan or commode and be unable to empty their bowels due to poor positioning or lack of privacy.
• Changes in the diet, including patients reducing fluid and fibre intake for fear of incontinence
• Difficulty swallowing, which results in requirement for thickened fluids and modified consistency diets. This can restrict consumption of adequate fibre and fluid
• Poor dentition, which can impact on dietary intake, including fibre-containing foods
• Limited care assistance available at mealtimes for dependent individuals, to ensure appropriate diet and fluid provision.
• Development of co-morbid medical conditions and resulting poly-pharmacy including, in particular, analgesics and psychotropic drugs.
• Mental health disorders such as depression, anxiety, dementia and cognitive impairment.
• Use of a number of medicines that induce constipation, including antacids, calcium and iron supplements, as well as radiotherapy and opioid pain relief for cancer treatment.
• Socio-environmental factors including hospitalization and institutionalization.

Medications that can contribute to constipation include:

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1. Pain medications (narcotics)
2. Antihistamines
3. Antidepressant and anti-psychotic medications
4. Some seizure medications
5. Iron supplements
6. Sucralfate and some antacids such as TUMS
7. Some blood pressure medications

Treatment:

1. Behavior changes: It is best to establish a regular pattern of bowel movement. People who have a normal bowel pattern usually defecate at approximately the same time every day. Since the bowels are most active after awakening and after meals, the most optimal time for a bowel movement is usually within the first two hours after waking and after breakfast. When the signals to defecate are ignored, these signals become weaker and weaker over time. Encouraging and allowing persons to pay attention to these signals can help decrease constipation.

2. Laxatives: Laxatives are substances that can help relieve constipation. However, the long-term use of laxatives can make your body depend on them. Talk to your health care provider about the use of laxatives to manage your constipation.
Fibre supplements are widely available and can be found in forms such as powders, tablets and capsules. If you have trouble eating enough fibre and want to use fibre supplements, check with your health care provider first.
Bulk forming laxatives are natural or synthetic products that have a laxative effect by absorbing water and increasing faecal mass.

3. Diet: For long term treatment it is always preferable to choose for a proper dietary management because intake of laxatives for a long period is not good for health. Increasing intake of fiber and fluid may help to feel less constipated and bloated.

Nutritional guidelines for alleviating constipation:

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When we experience constipation, it may be beneficial to include more insoluble fibre in the diet to promote regularity. It is important to increase fibre slowly over the course of a few weeks. Adding too much fibre too quickly can make constipation worse. Insoluble Fibre is not digested by the body and is excreted as waste. This is the type of fibre that promotes bowel regularity and discourages the development of haemorrhoids. Examples of foods that contain insoluble fibre include wheat bran, nuts, seeds, and skins on vegetables and fruits.

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• Drink plenty of liquids.
• Gradually increase  fibre intake.
• Eat 3-5 servings of fruits and vegetables daily.
• Choose foods that promote regularity.
• Try plum or prune juice.
• Try to include exercise or physical activity in  daily routine.
• Talk to your healthcare team about medication or supplements to help with constipation.

Proper dietary and lifestyle management can help in maintaining the normal bowel movements to a great extent. Medical interventions are required only when constipation arises because of some structural or functional change in the gastrointestinal tract.

Exercise and Constipation

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Exercise therapy has shown significant efficacy as a means of treating various intestinal diseases. Exercise, especially aerobic exercise, may be a viable and effective treatment for patients with constipation. Exercise helps constipation by lowering the time it takes food to move through the large intestine. This limits the amount of water that our body absorbs from the stool. Hard, dry stools are harder to pass. Aerobic exercise speeds up your breathing and heart rate. This helps to stimulate the natural squeezing (or contractions) of muscles in our intestines. Intestinal muscles that squeeze better will help to move stools out quickly. A regular walking plan — even 10 to 15 minutes several times a day can help the body and digestive system work at their best. Aerobic exercise includes running, jogging, swimming, or swing dancing, for example. All of these exercises can help keep the digestive tract healthy. Stretching may also help ease constipation, and yoga may, too.

 

You can join the programme of Foodnwellness. This program gives you a personalized plan that includes the key to eat the right quantity of food and healthier options that you need to eat for Constipation and will also motivate you to have a healthy lifestyle. You may receive plenty of advice from everywhere but it is worthy when you receive correct knowledge from panel of health professionals. Foodnwellness will always guide regarding every issue you face and it will be taken care of by our Dietitians.

Moong Dal Cheela/Pancake Recipe

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Moong Dal Cheela/Pancake Recipe

  • Author: Mubarra
  • Prep Time: 5 - 10 Minutes
  • Cook Time: 10 Minutes
  • Total Time: 12 minute
  • Category: Breakfast, Lunch, Dinner, Snack
  • Cuisine: Indian
  • Diet: Vegetarian

Description

Moong dal Cheela/Pancake is a healthy, delicious and quick to make recipe that can be consumed as a breakfast or snack item. It can be made with minimal ingredients and within minutes given, that the Moong dal is soaked overnight or for few hours before preparation. It can be served without any sides but it tastes best when served with homemade chutneys/pickle/curd/raita.

 


Scale

Ingredients

  • 1/4 cup Moong Dal (whole or split with husk) 
  • 1 tablespoon Green Peas
  • 1 tablespoon Water
  • 2 teaspoons of finely chopped Onion
  • 1/4 teaspoon of finely chopped Ginger 
  • 1/4 teaspoon of finely chopped  Coriander leaves 
  • Salt to taste
  • 1/4  teaspoon of finely chopped Green Chili 
  • 1  teaspoon ghee or Oil

Instructions

  • Wash and soak the moong dal for around 3-4 hours prior to making the batter.
  • Then take the soaked and drained moong dal, blend it in a mixer along with green chillies, green peas, ginger, using little water to make a thick paste.
  • In a bowl, add onion, coriander leaves, salt and the blended moong dal and peas paste.
  • Mix well and add water to make a thin dosa like batter. Remember to add water in small batches to get your desired consistency (Medium thick consistency)
  • Heat a large nonstick frying pan on medium-high heat. Add a little oil to coat the pan.
  • Pour a ladle full of batter when the pan is hot and flatten out until 1cm thick. 
  • Pour a little oil on either side and cook until golden brown.
  • Flip and cook on the other side. 
  • Serve hot with any Chutney/Pickle/Salsa/Curry

Notes

The Moong dal Cheela/Pancake can be stuffed with or topped with vegetables of your choice to make it more nutritionally balanced.


Nutrition

  • Serving Size: 1
  • Calories: 167.75 Kcal
  • Fat: 5.325 g
  • Carbohydrates: 21.11 g
  • Protein: 8.79 g

Keywords: Breakfast, Lunch, Dinner, Snack, healthy, vegetarian, Protein, weightloss

Risk of heart disease from Diabetes

Diabetes increases the risk of heart disease by four to five times as compared to a non-diabetic person. Hence apart from blood sugar control diabetics also need to pay close attention to controlling their blood pressure and cholesterol levels.

Diabetics need to have a more stringent lifestyle control as compared to normal people. Lifestyle changes along with weight loss will lead to significant improvement in blood sugar levels.
People suffering with high blood pressure (known as hypertension) are more than twice as likely to suffer a heart attack or stroke as those with normal blood pressure. Hence diabetics need to keep their blood pressure as close to the ideal as possible, and always less than 130/80 millimeters of mercury (mm Hg).

The general dietary recommendations for diabetes will include, complex carbohydrates(like whole grain pastas, brown rice) avoid processed carbohydrates(like refined flour, polished white rice), prefer raw fruits over fruit juices, include protein (lean meat, eggs, lentils, beans, dairy), green leafy vegetables, avoid raw sugar & sweat treats.

Increasing physical activity, and losing weight—should help to lower your blood pressure. If diet and exercise alone do not bring your blood pressure into a healthy range, medications may be necessary to lower it.

Since diabetes increases your risk for cardiovascular disease, including heart attack and stroke, one should pay close attention to factors that can put you at greater risk for heart trouble. These are often referred to as the ABC’s:

  1. Haemoglobin A1c (HbA1c) blood sugar test
  2. Blood Pressure
  3. Cholesterol

 

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.

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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