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Gallstones

January 23, 2016January 13, 2021Meenu Agarwal2 Comments

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.

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

January 23, 2016January 13, 2021Meenu AgarwalLeave a comment

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.

Lactose Intolerance

January 21, 2016January 13, 2021Meenu AgarwalLeave a comment

We commonly hear from people of all age groups, particularly children and elderly to be complaining of abdominal discomfort after consuming milk. Some individuals are able to tolerate a small quantity while others are unable to tolerate even a small amount. This could be due to lactose intolerance.

Lactose intolerance relates to insufficiency of the disaccharidase enzyme ‘lactase’ which is found in the greatest quantity in the outer membrane of the mucosal cell of the jejunum. The degree of lactase deficiency may vary in individuals. Lack of lactase does not break down the disaccharide sugar – lactose present in milk, to glucose and galactose, it passes unchanged into the large intestines where it gets converted to lactic acid by the bacteria, which subsequently cause diarrhea and other symptoms of discomfort, distension and abdominal pain. The problem is gene related and often seen in infants and young children commonly, but may also present in adults.

Common Symptoms of Lactose Intolerance include:

Anorexia and nausea, Intestinal distention, Abdominal cramps, Gas and flatulence, severe diarrhea, Under – nutrition and loss of weight.

Diagnostic tests are available to provide information about the level and activity of the lactase enzyme. Depending on the level of activity, the dietary treatment could be planned .

Pancreatitis

January 21, 2016January 13, 2021Meenu AgarwalLeave a comment

The pancreas is a large gland behind the stomach and next to the small intestine. The pancreas has 2 main functions:

It makes enzymes, which help digest proteins, fats, and carbohydrates before they can be absorbed in the intestine.
It makes hormones (chemicals made from glands), the most important of which is insulin, which control how the body uses and stores sugar (glucose), its main source of energy.

Pancreatitis is a disease in which the pancreas becomes inflamed. Pancreatic damage happens when the digestive enzymes are activated before they are released into the small intestine and begin attacking the pancreas.

There are two forms of pancreatitis – Acute and Chronic.

Chronic pancreatitis is inflammation of the pancreas that does not heal or improve – it gets worse over time and leads to permanent damage. Chronic pancreatitis eventually impairs a patient’s ability to digest food and make pancreatic hormones. Chronic pancreatitis often develops in patients between the ages of 30 and 40, and is more common in men than women.

Whereas there are causes of chronic pancreatitis that are unknown; several factors have been identified to cause chronic pancreatitis:

Heavy alcohol use
Autoimmune conditions (when the body’s immune system attacks its own body)
Genetic mutations due to cystic fibrosis
Blocked pancreatic duct or common bile duct
Familial pancreatitis (runs in the family—with 2 or more immediate family members with a history of pancreatitis)

Symptoms of Chronic Pancreatitis

Most individuals with chronic pancreatitis experience upper abdominal pain, although some have no pain at all. The pain may spread to the back, become worse with eating or drinking, and become constant and disabling. Other symptoms include the following:

Nausea
Vomiting
Losing weight without trying
Oily, smelly stools (steatorrhea)

Individuals with chronic pancreatitis frequently lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to digest food, so nutrients are not absorbed normally, leading to malnutrition.

Acute Pancreatitis

Acute pancreatitis is an inflammatory condition of the pancreas that is painful and at times deadly. Diagnosis of pancreatic problems is often difficult and treatments are therefore delayed because the organ is relatively inaccessible.

Causes and Symptoms of Acute Pancreatitis

The most common cause of acute pancreatitis is stones in the gallbladder. Gallstones pass through the common bile duct to enter the small intestine. At the entry of the small intestine, the main pancreatic duct joins or lies immediately next to the common bile duct. It is believed that stones that get stuck in the common bile duct impinge on the main pancreatic duct, causing an obstruction of the normal flow of pancreatic fluid and leading to pancreatic injury. Another way that a stone can cause pancreatitis is by causing a backflow of bile into the pancreatic duct, resulting in pancreatic injury

Acute pancreatitis usually begins with gradual or sudden pain in the upper abdomen that sometimes extends to the back. The pain may be mild at first and become worse after eating. The pain is often severe, constant, and commonly lasts for several days in the absence of treatment. A person with acute pancreatitis usually looks and feels very ill and needs immediate medical attention. Other symptoms can include:

Swollen and tender abdomen
Nausea and vomiting
Fever
Rapid pulse

Nutrition plays a very important role for patients suffering from pancreatitis.

Ulcerative Colitis: Ulcer of the Colon

January 21, 2016January 13, 2021Meenu AgarwalLeave a comment

Ulcerative colitis is a chronic inflammatory disease of the gastrointestinal (GI) tract, called inflammatory bowel disease (IBD). Ulcerative colitis most often begins gradually and can become worse over time.

Cause of Ulcerative Colitis

The exact cause of ulcerative colitis is unknown. Researchers believe the following factors may play a role in causing ulcerative colitis:

overactive intestinal immune system
genes
environment

Signs and Symptoms

The most common signs and symptoms of ulcerative colitis are diarrhea with blood or pus and abdominal discomfort. Other signs and symptoms include

an urgent need to have a bowel movement
feeling tired
nausea or loss of appetite
weight loss
fever
anemia—a condition in which the body has fewer red blood cells than normal

The symptoms a person experiences can vary depending on the severity of the inflammation and where it occurs in the intestine.

People who have ulcerative colitis for 8 years or longer also have a greater chance of getting colon cancer. The longer you have had ulcerative colitis, the greater your risk

Everyone is different, (different tolerances, different likes and dislikes, different locations for their disease in the GI tract), nutritional approaches must be customized to fit every individual.

When you are in remission, you can best help yourself by eating a well-balanced diet. There is no need to avoid any particular kind of food or to follow a restrictive diet. However, there are certain foods that people find harder to digest, such as foods containing insoluble fibre, seeds and nuts, and raw fruits and veggies.

During a flare-up, you may want to modify your diet to avoid aggravating an already sensitive gut. There are certain things that you can to do help you through an acute flare up.

Hypercholesterolaemia (Elevated Cholesterol levels)

January 21, 2016January 13, 2021Meenu AgarwalLeave a comment

Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body. Your body needs some cholesterol to work properly. But if you have too much in your blood, it can combine with other substances in the blood and stick to the walls of your arteries. This is called plaque. Plaque can narrow your arteries or even block them. Increased cholesterol in blood is called hypercholesterolaemia.

High levels of cholesterol in the blood can increase your risk of heart disease. Your cholesterol levels tend to rise as you get older. There are usually no signs or symptoms that you have high blood cholesterol, but it can be detected with a blood test. You are likely to have high cholesterol if members of your family have it, if you are overweight or if you eat a lot of fatty foods.

You can lower your cholesterol by exercising more and eating more fruits and vegetables. You also may need to take medicine to lower your cholesterol.

Classification of total cholesterol

Desirable level is less than 200 mg/dL
Borderline level is between 200-239 mg/dL
High level if it is more than or equals 240 mg/dL

Symptoms of High Cholesterol in blood

High blood cholesterol usually has no signs or symptoms. Thus, many people don’t know that their cholesterol levels are too high.

Weight Management

If you’re overweight or obese, losing weight can help lower LDL cholesterol. Maintaining a healthy weight is especially important if you have a condition called metabolic syndrome.

Metabolic syndrome is the name for a group of risk factors that raise your risk for heart disease and other health problems, such as diabetes and stroke.

The five metabolic risk factors are a large waistline (abdominal obesity), a high triglyceride level, a low HDL cholesterol level, high blood pressure, and high blood sugar. Metabolic syndrome is diagnosed if you have at least three of these metabolic risk factors.

Physical activity

Routine physical activity can lower LDL cholesterol and triglycerides and raise your HDL cholesterol level. People gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week. The more active you are, the more you will benefit.

Diet Modification

Dietary modification holds an important role in the control of high cholesterol. In other words, high cholesterol can be controlled by following a proper nutritious diet which is low in dietary fat.

Hypothyroidism

January 18, 2016January 13, 2021Meenu AgarwalLeave a comment

Hypothyroidism results from deficient production of thyroid hormone by the thyroid gland. Since the thyroid hormones regulate metabolism in every cell of the body, a deficiency can affect virtually all body functions. Deficiency of thyroid hormones can result from lack of stimulation by the pituitary gland, defective hormone synthesis or impaired cellular conversion of T4 to T3. No matter what the cause, symptoms such as low energy, fatigue, cold hands and feet, muscle pain, depression and cognitive deficits are common.

Primary hypothyroidism is caused by an inherent inability of the thyroid gland to produce a sufficient amount of thyroid hormone. About 95% of overt hypothyroidism is primary. Iodine deficiency is the most common cause of primary hypothyroidism. The second most common cause is referred to as “post-theraputic hypothyroidism” due to surgery or radiation therapy for hyperthyroidism. However, primary hypothyroidism can also result from genetic defects, inhibition by drugs or chemicals, cancer, and iodine deficiency or excess.

In any case, the loss of functional tissue leads to a decrease production of TH to which the pituitary responds with an increased production of TSH which increases the synthesis of thyroglobulin, which may lead to thyroid enlargement and goiter results. Laboratory tests reveal elevated TSH with decreasing levels of TH reflective of the severity of the hypothyroidism. Maintenance of T3 levels until the late stages of hypothyroidism is accomplished by both increased secretion of T3 by the thyroid and increased conversion of T4 to T3 in the peripheral tissues.

Secondary hypothyroidism is due to inadequate stimulation of a normal thyroid gland by TSH from the pituitary. Most commonly, this is the result of pituitary tumors (or their treatment) or trauma but can also occur at the level of the hypothalamus. Lab tests will reveal very low TSH levels along with low levels of TH.

Cellular hypothyroidism is a third, less common. Symptoms of hormone deprivation result from a disorder in the peripheral tissues that reduce their responsiveness to TH (TH resistance) or that inactivate the hormone. Lab tests will reveal normal TSH and hormones but there will be low functional thyroid activity (low BMR, low temp)

Clinical symptoms: The characteristic sign of severe, chronic hypothyroidism is myxedema. Myxedema is the result of the build-up of a protein-mucopolysaccharide complex that binds water and produces a non-pitting edema especially around the eyes, hands and feet. It also causes a thickening of the tongue and mucous membranes of the laryngeal and pharyngeal area causing hoarseness and slurred speech.

The symptoms of hypothyroidism usually have an insidious onset and the patient may be unaware of them for years before reaching the stage of myxedema.

Other Signs and Symptoms: Decreased levels of thyroid hormone leads to a general decrease in the metabolism of fats, proteins and carbohydrates and often result in weight gain, dyslipidemia and an increased risk of cardiovascular disease. Dry skin and hair, brittle nails and significant hair loss are common, and along with a poor tolerance to cold may be some of the first symptoms. Loss of libido, menstrual abnormalities, constipation, muscle weakness and joint stiffness are predominant features although depression, weakness and fatigue are usual.

Difficulty in losing weight is a common complaint of people with an underactive thyroid. Successful weight loss is usually a multi-step process, that includes the following steps:

Optimize Thyroid Treatment: For many patients, to lose weight, it’s not enough to have normal thyroid levels or in the reference range. They need to be optimal. That means a TSH typically below 2.0, Free T4 and T3 in the upper end of the reference range, and lower Reverse T3.

Optimize Blood Sugar: Your fasting glucose level should be balanced.

Balance Hormones: If sex hormones (estrogen, progesterone, testosterone), and adrenal hormones (cortisol, DHEA) are out of balance, this can make weight loss more difficult. Menopause as well as estrogen dominance, can make weight loss more difficult. Lack of testosterone in men and women can make it harder to build muscle. Adrenal imbalance can make you tired, less responsive to thyroid treatment, and less able to lose weight. Evaluating these hormones, and resolving imbalances may be a key step in helping you in your weight loss effort.

Optimize Thyroid Treatment: For many patients, to lose weight, it’s not enough to have normal thyroid levels or in the refence range. They need to be optimal. That means a TSH typically below 2.0, Free T4 and T3 in the upper end of the reference range, and lower Reverse T3.

Optimize Blood Sugar: Your fasting glucose level should be balanced.

Balance Hormones: If sex hormones (estrogen, progesterone, testosterone), and adrenal hormones (Cortisol, DHEA) are out of balance, this can make weight loss more difficult. Menopause as well as estrogen dominance, can make weight loss more difficult. Lack of testosterone in men and women can make it harder to build muscle. Adrenal imbalance can make you tired, less responsive to thyroid treatment, and less able to lose weight. Evaluating these hormones, and resolving imbalances may be a key step in helping you in your weight loss effort.

Food Selection: Eating two to three meals a day, no snacks, and avoiding food after 8 p.m. seem to help balance hunger hormones and blood sugar, and promote fat burning.

Iodine Deficiency: Iodine is a building block for thyroid hormone. Care should be taken so as to not deprive of iodine in daily diet. The best way to include iodine in your diet is with iodine-rich foods – seaweed, shrimp, dried prunes, lobster, cranberries – or use an iodine rich salt.

Goitrogens: Avoid excessive intake of goitrogens. Goitrogens are foods that can induce iodine deficiency by combining with iodine and making it unavailable for use by the thyroid. Foods such as broccoli, cabbage, cauliflower, Brussels sprouts, turnips, walnuts, almonds and soy are considered goitrogenic. Cooking usually neutralizes the goitrogens in these foods.

Nutrition for Hypothyroidism: Protein, Selenium, Magnesium, Iodine, Zinc, vitamin B-12, vitamin B2, vitamin A, vitamin D and vitamin C are important for thyroid function. Make sure your diet has enough of these nutrients or supplements for these vitamins are advisable.

Physical activity: Encourage routine exercise. Exercise stimulates thyroid hormone synthesis, tissue sensitivity and decreases stress, which can interfere with the conversion to active T3.

Also, one should aim to sleep seven or more hours per night as lack of sleep contributes to weight gain and makes weight loss more difficult.

Tag: lifestyle

Gallstones

Causes of gallstones

Preventing gallstones

Diet

Losing weight

High Blood Pressure

Lactose Intolerance

Pancreatitis

Ulcerative Colitis: Ulcer of the Colon

Hypercholesterolaemia (Elevated Cholesterol levels)

Hypothyroidism

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Causes of gallstones

Preventing gallstones

Diet

Losing weight

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