chatwithketch

Q: Please, I need to know about gastric ulcers and can it be cured?

A: Gastric ulcer is a type of peptic ulcer and this condition is often confused with Gastro-Esophageal Reflux Disease (GERD).

Gastric acid is secreted normally in the stomach to help the process of digestion. Peptic ulcer is a sore in the stomach, esophagus or duodenum and occurs when there is either over-production of this gastric acid in the stomach or reduction in the quantity of mucous that protects the stomach from the acid. Infection with an organism, Helicobacter pylori (H. pylori) has been found to be a cause of peptic ulcer.

GERD, on the other hand occurs when stomach acid backtracks into the esophagus causing heart burn.

In the past, it was thought that spicy foods caused peptic ulcers. However, there’s no evidence to support this, though spicy foods can certainly make the symptoms of ulcer worse  Smoking, stress and drinking alcohol are also likely to worsen the symptoms of peptic ulcer. Caffeinated and carbonated beverages may also be culprit.

Ulcers are also common in people who take certain pain relieving drugs known as Non- Steroidal Anti-Inflammatory Drugs (NSAIDs) like Ibuprofen.

People with peptic ulcer usually complain of abdominal pain or even sometimes, chest pain as the pain can be anywhere from the breast bone to the navel…giving room for a wide range of descriptions  The pain is usually worse at night or when the stomach is empty.

People with ulcers may vomit blood or pass out fresh or altered blood in stool. For the latter, the stool looks tarry black. Complications of peptic ulcers include internal bleeding, leakage of the acid into the abdominal cavity etc

Treatment is targeted at reduction in acid production, neutralization of acid, treatment of Helicobacter infection, promotion of healing or protection of stomach lining. Your doctor will determine the best option or combination(s) with your active participation, of course

Thus, prevention is targeted at switching pain relieving drugs (if you have an ulcer, please stay away from NSAIDs, reducing your level of stress, stopping smoking and reducing your alcohol intake. Maintaining a healthy diet filled with loads of fruits and veggies which provide sufficient vitamins to aid healing, is also a good way to go. It is still not very clear how H. pylori infections spread but it is thought to be probably from person to person or from food and water. So, judicious and very frequent, hand washing will certainly help

Does milk help? Well, temporarily but it quickly makes it worse. Milk coats the surface of the stomach, reducing the pain but then stimulates more acid production. Sounds like you can’t win, aye?! ;D

For GERD, there are also conditions like pregnancy and obesity that make this condition worse and there are also foods that encourage this. Examples of these ‘foods’ are fatty foods, alcohol, orange juice, chocolate and coffee, onions, tomatoes, peppermint and spicy foods.

So for the person in the question, I suggest you keep a food diary over a period of time and try to figure out the trigger foods. If you suspect tomatoes, try to confirm this by having a ‘tomato meal’ and watching for heart burn and an unpleasant taste at the back of the mouth. If this is not the issue, perhaps it’s a weight issue or even over-eating.

Treatment is targeted at the acid and healing the esophagus. Remember that occasional heart burn is not regarded a problem but if it happens frequently, like two or more times every week, then it becomes a problem and is now referred to as Gastro-Esophageal Reflux Disease (GERD). So, drugs used can stop acid production, reduce acid production and cause healing of the esophagus or neutralize the effect of the acid.

Prevention involves trying to avoid your trigger foods (quite a number are actually healthy  maintaining a healthy weight, avoiding heavy meals just before bedtime, try eating smaller meals and avoid tight clothes that may also put pressure on your abdomen.

So, see a doctor first to confirm the diagnosis….peptic ulcer or GERD and then he’ll advice on treatment.

Have a fabulous evening and remember…no heavy meals before bedtime

Q: Please ma’am, my wife went for a pregnancy scan and came home with this result. Can you please help me understand it? 1. A relatively bulky, gravid and anterverted uterus. 2. Endometrial cavity harbors a well-defined gestation sac. A fetal pole (with cardiac motion) and a yolk sac are noted within. 3. Homogeneous myometrial echotexture; nil fibroid mass. 4. A 25mmx28mm right corpus leutem is noted. 5.CRL=14mm. 6.AVG.GA=7weeks5days. 7. FHR=159BPM. IMPRESSION. 1. Intact early cyesis. 2. cervix is closed. thanks. I am hoping for a quick reply.

A: The uterus being bulky means that it’s bigger than the usual pre-pregnancy state. It could be due to any number of reasons. The scan tells us the uterus is gravid, meaning, pregnancy is the reason.

Gestational sac is the first sign of pregnancy seen on ultrasound and it encompasses the embryo (baby) and the amniotic fluid (the fluid that surrounds the baby in the womb). The presence of a fetal pole with cardiac motion confirms there is a fetus (baby) in the womb and it is alive and well J

A homogenous myometrial echo-texture signifies a womb that is normal and free of any lump like a fibroid.

In a woman of child bearing age, an egg forms and matures within a follicle found within the ovary. During ovulation, the egg is released and the follicle transforms into a structure called the corpus luteum. If fertilization and pregnancy occurs, the corpus luteum maintains the pregnancy by secreting hormones.

The CRL (crown rump length) is used to date the pregnancy. Your wife’s pregnancy appears to be 7 weeks and 5 days – almost 2 months old

The FHR is the fetal heart rate – 159 beats per minute.

The impression made by the sonologist is intact early pregnancy. A closed cervix is good and normal in pregnancy. People with incompetent (open) cervix are more likely to lose their pregnancies.

So, congratulations and all the best to you and wifey! 😀

‘It’s easy to eat your way to an alarmingly high cholesterol level. The reverse is true, too — changing what foods you eat can lower your cholesterol and improve the armada of fats floating through your bloodstream.’

Read!https://www.health.harvard.edu/heart-health/11-foods-that-lower-cholesterol

Is it possible to have too much of a good thing? from when we were young, we’ve been told to stock up on our proteins. Those of us who are vertically challenged wonder why we didn’t eat more proteins, so how can someone possibly say it is possible to overdo it?! Well, it is possible to overdo it! Moderation is always key in everything. For more tips, please read the post below and for a related topic, click on this link: https://chatwithdrketch.com/2015/06/26/daily-health-tips-how-can-i-get-more-proteins/

https://www.health.harvard.edu/diet-and-weight-loss/when-it-comes-to-protein-how-much-is-too-much?utm_source=delivra&utm_medium=email&utm_campaign=WR20180518-HealthyEating&utm_id=918689&dlv-ga-memberid=11052531&mid=11052531&ml=918689

Been wanting to write on this, but Harvard Health blog beat me to it! Do you know that the hot air hand dryers in rest rooms may be spreading germs, while drying your hands? Ever wondered where the hot air inside it comes from? No? Oh dear! You should read this!

https://www.health.harvard.edu/blog/the-bacterial-horror-of-the-hot-air-hand-dryer-2018051113823

Q: Good morning doctor, 27weeks gone and I don’t want my baby to be big. Please can I take Lipton tea and zobo without sugar? Thanks Dr.

A: Zobo is a drink made from the Hibiscus flower. This drink is known by many other names depending on where you come from. Some popular names include Karkadi, Karkada, Zenaf, Sour tea, Roselle and of course, Zobo! There are many more names, by the way…but this post is not about the many names of Zobo.

Some people drink Zobo, because there is an assumption that it is a healthier alternative sugary, soft drinks. Well, it depends. If you prepare it with bottles of the sugary soft drinks you were trying to avoid ab initio, then maybe, it may not be so healthy, right? 😀

Again, some of the touted benefits of Hibiscus on hypertension, cholesterol levels, colds etc do not really have significant medical evidence to back them up.

However, it has been shown that taking Zobo with Acetaminophen (our regular Paracetamol) may lead to a situation where your body gets rid of the drug faster than it would have done ordinarily. This implies that in a short while the effect of the Paracetamol would have worn off and the person probably back with the ache.

There is not sufficient evidence to really confirm that zobo and a lot of other herbal drinks are safe in pregnancy. It has been suggested in some quarters that Hibiscus in excessive amounts could lead to menstruation leading to miscarriages in pregnant women. The evidence for or against this is not in great supply but it is probably a great idea to give it a miss during pregnancy. I would do so 😀

Tea contains caffeine. There are conflicting reports as to whether some amount of caffeine is beneficial in pregnancy (less than 200mg) or whether increased amounts are a problem > or more than 500mg). One regular teabag steeped in a small teacup has about 55mg of caffeine. So, it may be a good idea to limit your consumption of tea. Big babies are usually seen in women who

• Are diabetic.
• Have gestational Diabetes (Diabetes that is observed during pregnancy),
• Are obese
• Have had another big baby before
• Have had a lot of babies (from the 5^thpregnancy, the risk of big babies increase)
• Excessive weight gain during pregnancy
• Are older. From age 35 years, the risk of having a big baby increases
• Have pregnancies that are overdue. When a pregnancy is more than 2 weeks overdue, the chances of a big baby are increased

For women with big babies (fetal macrosomia), a vaginal delivery may not be a complete no no! However, your OBGYN will weigh the risk of that against your medical history and other pre-existing medical conditions. Potential complications include having genital tract tears during delivery, prolonged labour and rupture of the uterus. The babies may be born with a higher than normal blood sugar level and be prone to childhood obesity.

However, none of this needs to happen if you eat nutritious foods and watch your portions. You should also register in a good center under the care of a qualified obstetrician.

To prevent having a big baby, remember that feeding for 2 is a fad. You don’t really need to eat like a horse 😀 …you and your baby don’t need that much (an average of 12kg weight gain for 9 months…little over 1kg/month!); include some exercise (gentle stretches and walks, with your doctor’s knowledge and advice) and be sure that Diabetes is controlled, if you have this before pregnancy.

The link to my post on weight gain during pregnancy is included here to provide more information. https://chatwithdrketch.com/2013/12/02/daily-health-tips-eating-for-two/

So, for the remainder of your pregnancy, be sure to follow your doctor’s instruction on weight gain, medications etc. to the letter! Let’s share the good news when the baby is born.

All the best!

Q: I am having a problem with my penis every time I feel like having I always experience a bad pain to my penis and after ejaculates its even failing to get into its normal size not until I deep it into cold water what could be the problem please

A: Hi there! Thanks for writing in.

The condition you describe sounds like priapism. Priapism is a condition, in which there is a sustained and oftentimes, painful erection of the penis, continues for hours beyond sexual stimulation or even when there is no sexual stimulation. It is more common in men in their 30s.

There are three types of priapism (ischaemic, non-ischaemic and recurrent) but to understand this, we’ll take a look at the mechanism of erection. An erection occurs in response to stimulation, physical or psychological. As a result of this stimulation, the blood vessels and smooth muscles of the penis relax, allowing increased blood flow to the penis. This is what causes erection. When the stimulation is over, the vessels and smooth muscles constrict causing the blood to flow out of the penis and become flaccid. In priapism, the order of events causing the blood to flow out of the penis is changed such that the blood does not flow out of the penis

In ischaemic priapism, which is the more common type due to inability of blood to leave the penis, there is pain, rigid penile shaft but flaccid glans (penile tip) and the erection lasts more than 4 hours! Causes include blood disorders like sickle cell anaemia and injuries to the penis and/or pelvis, alcohol, cocaine and other illicit drug use, some medications like blood thinners and antidepressants, cancer of the penis etc.

Non-ischaemic priapism is usually due to an injury to the perineum or genitals that results in poor regulation of penile blood flow. It is not usually painful and manifests as erection that lasts for more than 4 hours but the penile shaft is not fully rigid.

In recurrent priapism, situation is similar to ischaemic priapism with erections that are painful, recurrent but ease after 2 to 3 hours. These erections may subsequently progress to become more frequent and more prolonged. It is common in males with sickle cell anaemia

Any sort of priapism should be checked out with a medical doctor (urologist) to determine type, cause and management. Erection lasting more than 4 hours is an emergency and may led to damage of the penis and subsequent erectile dysfunction

Treatment depends on cause and should be started as soon as possible.

Options include aspiration (in which blood is drained out of the penis with a syringe), use of medications to constrict the penile blood vessels, treatment of underlying medical condition like sickle cell anaemia and surgery in some cases. Note of warning, though it sounds very simple to use a syringe to drain out the blood in the penis, you must never attempt it on your own. You must visit a hospital and let a doctor work out the best treatment option(s) for you.

Patients who do not get treated early enough and some that went through surgery eventually end up with poor erectile functions despite the successful treatment.

All the best!