chatwithketch

Q: Hi, Doctor. I want to know what causes the anus to itch and what can someone do to relieve the itching?

A: I watched a comedy skit once where a lady sat on the floor and shuffled forward in a rather embarrassing way because she had an itch on her bottom! That was funny to watch but in real life, would have been downright embarrassing for both the person with the problem and the person watching.

Anal itch is itching in and around the anus and could be due to:

• Infections: These could be bacterial (streptococcal or staphylococcal, fungal (the organism responsible for candidiasis), parasitic (due to worms like thread worms or even scabies), viral or due to sexually transmitted infections.
• Personal care products: Using products that irritate the skin eg perfumes, toilet paper etc
• Skin conditions like psoriasis
• Other medical conditions like haemorrhoids, long term diarrhea, long term constipation, diabetes, kidney failure etc
• Medications which may either cause the itch or make an already existing itch worse eg peppermint oil or even creams used for haemorrhoids.

A once in a while itch may not be a problem, but you need to get your doctor to take a look if you find that the itches are associated with bleeding, is persistent and/or anal area appears infected.

Given the wide array of causes, treatment is dependent on identified cause. If infections are the problem, they need to be treated, if due to personal care products, try switching what you use. Specific medical conditions need to be treated and medications can be changed or dosage adjusted. Your doctor will advise. If your itch appears more at night, an anti-histamine medication to stop the itch will be given in the first instance.

In the meantime, try to avoid scratching. I can almost see the look on your face, like , ‘yeah, right! It’s so easy not to scratch and yet I decided to write about it!’. I know, I know, but scratching just irritates the skin around the anus some more and may make you more prone to infections. So, to deal with the itch urge, use can place a cold compress there (just put some ice cubes in a small towel, cover it up and place where needed).

• You also need to cut your finger nails to ensure that even if you do scratch while sleeping, you do not hurt yourself.
• Be sure to cleanse thoroughly after having a poo. Plain tissue may hurt so you may want to consider using water to wash up and or wet a big ball of cotton wool…please don’t flush this oh!!! 😀
• Dress comfortably…cotton underwear and loose clothing help to prevent friction where you don’t need it J
• Avoid constipation and diarrhea. Just keep your tummy contents moving smoothly by eating right and exercising
• Avoid personal care products that cause irritation like heavily perfumed soaps, tissues etc

I hope this helps you.

Have a fabulous week ahead 😀

Q: Good evening ma’am. My back is bent and I am 18 years. Please, help me. What can I do?

A: Hi dear, thanks for writing in. I’m sorry to hear about your problem. Though you did not mention the direction of bend, let’s see if we can make sense of it though.

Your backbone is not exactly straight, in its normal form because it curves forwards as it runs up your back. There are three types of disorders that can affect the backbone:
Kyphosis, a condition in which the forward curvature of the backbone is exaggerated. In local parlance, people with this condition are said to have hunch/hump back.

Lordosis, a condition in which there is an exaggerated inward curve at the lower back. This is the typical gait of a pregnant woman.

Scoliosis, a condition in which there is a marked sideways curvature of the spine, such that the people with this condition appear to have an S-shaped spine.

Symptoms of kyphosis include:
• Hump at the upper back
• The head is usually bent forward when compared to the rest of the body

Causes of kyphosis include:
• Osteoporosis also known as brittle bones.
• Poor posture
• Infections of the spine
• Tumours (growths) of the spine
• Arthritis
• Birth defect

Treatment for kyphosis includes:
• Exercises and physical therapy
• Anti-inflammatory medication
• Wearing back brace
• Surgery

Symptoms of lordosis include:
• Exaggerated gap between back and floor when lying down
• Back pain

Causes of lordosis include:
• Obesity
• Inflammation of the disc space between the spinal bones
• Osteoporosis, also known as brittle bones. For more on this topic, please click on https://chatwithdrketch.com/2014/06/01/daily-health-tips-do-i-need-milk/ and https://chatwithdrketch.com/2015/06/13/watch-the-dr-ketch-show-osteoporosis-brittle-bones/

Treatment options for lordosis include:
• Weight loss
• Anti-inflammatory medication to reduce swelling and pain
• Wearing back brace
• Exercise and physical therapy
• Surgery

Symptoms of lordosis include:
• Leaning towards one side
• Uneven shoulders as one appears higher than the other

Causes of scoliosis include:
• Inheritance: This tends to run in families
• Birth defect
• Injury
• Infection
• Some cases also do not appear to have any specific cause especially the most common type in teenagers.

Treatment options for scoliosis include:
• Observation, if the defect is slight
• Back brace, for adolescents and children to prevent curve from getting worse.
• Surgery

So, please see an orthopaedic surgeon who will diagnose your specific case and advice on options available to you.

All the best.
Have a great weekend, everyone 😀

A new study suggests that, if done safely and for enough time to meet the recommended guidelines, weekend-only exercise can be beneficial.

Source: The underappreciated health benefits of being a weekend warrior

Do you find yourself dealing with back pain, again and again? You should read this!

http://www.health.harvard.edu/healthbeat/4-ways-to-turn-good-posture-into-less-back-pain

Q: Good day mums. Please help a first time mum to be. I have always been a plus sized lady even before I got married and now pregnant. I had a chat this afternoon with which I told her I weigh 110kg at 7 months and she really scared me by saying I will have complications like HBP and co during delivery. I sincerely have been so down since she left. Please mamas I need words of encouragement and tips to help manage my weight though I have had a smooth pregnancy so far and am averagely tall. THANK YOU

A: Hello dear, thanks for writing in and congratulations on your pregnancy. There’s no need to be scared. You just need to arm yourself with information and follow through.

Pregnancy is associated with increased cravings and of course growth of the baby, but you do not need significantly more calories to cope with this state. The recommended weight gain for pregnancy is 8 – 16 kg in all (with an average of 12kg).

During your first trimester, you actually do not need more calories than when you were not pregnant. You can continue with the activities you used to do before including exercise. However, exercise should be toned down from vigorous to moderate. Moderate exercise is any physical activity that you perform that but you’re still able to carry on a conversation without running out of breath…that’s as simple an explanation as it goes :D. It includes walking, swimming, dancing, pregnancy exercises (these are taught in some antenatal classes), stretching and relaxation exercises. Remember that you must never start on any exrcise regimen without discussing with your doctor who knows your specific medical history.

Please note that you should never to exercise to the point of exhaustion, not to over-heat yourself and not to carry on any jumping etc…partly because you are prone to injuries of the ligaments (like sprains)and because, it’s just not safe at the time. I always used to know I was pregnant whenever I sprained my ankle…it happened in 2 out of 3 pregnancies! It may not be an exact science, but it worked for me :D. Just kidding…don’t try this at home 😀

During your second trimester, your calorie needs start to increase. The recommended increase in calorie intake is about 300 calories per day. Does this sound like much? It actually is not! A cup of cereal with a banana and a cuppa tea…..it’s all gone! 😀 So, imagine the quantum of calories in the other junk foods we crave for during this time! Take the time to read labels of food packs and check what a serving size is. If there are two serving portions in a tub of ice cream and you finish the whole tub, you’ve clearly eaten double the calories that is written on the tub!

In the final trimester, the calorie requirement increases some more to about 400 calories per day. Note that for multiple pregnancies (twins, triplets etc), the calorie needs are extra 400 calories in second trimester and extra 500-600 calories in the third trimester.

So, what to eat? The same things you did before you hot pregnant…assuming you were eating right :D. More fruits and veggies, complex carbohydrates (they are rich in fibre and keep you feeling full for a longer period of time) like beans, oatmeal, sweet potatoes, brown rice etc. Load up on proteins too (fish, chicken etc), calcium tich foods like yoghurt, skimmed milk…you don’t want to experience those muscle cramps of pregnancy. They can be excruciating! I know…I’ve had them J

Eat 5 small meals a day: breakfast, snack, lunch, snack and dinner. This should keep the hunger pangs at bay and deal with the cravings. You probably will still crave stuff: Iyalamala’s food, ice cream with all the toppings, a ‘ginormous’ burger etc and guess what? You can give in once in a blue moon, just don’t make it a habit! If you take in more calories than you need, you run the risk of having a big baby with all the complications associated with that during pregnancy and delivery and of course, it’s harder to get back to your pre-pregnancy weight after the baby.

After having your baby, breast feeding comes in, if you’re exercising and eating right, breastfeeding can help lose weight…as much as 300 calories per day. Does tying a wrapper tightly round your waist help flatten tummy? Honestly, I’ve heard people who swear by that technique. So, what I’ll say is, if it works for you, why not? Just don’t tie so tight as to stop blood flow 😀

How soon to start exercise after having a baby? Well, it depends on how active you were before and during pregnancy. If you were very active, you can start some light stretches as soon as you feel able. However, generally, we advise 6 – 8 weeks after birth to allow for a post-natal check to have been done. Again, start small and allow your body to get into the groove.

Other mums….she asked you too! How do you get back into shape after having your baby? Help out a FTM!

Have a good night y’all 😀

Q: Thanks million for the good job you are doing. Please this is my first post. I took vitamin E since last week saturday to precisely. I have been stooling since then. What should I do?

A: Vitamin E is a fat-soluble vitamin with anti-oxidant properties. Anti-oxidants help fight cancer, build and maintain body’s immunity such that you can fight off diseases faster and better etc.

Foods rich in Vitamin E include eggs, green leafy veggies, grains, nuts, olive oil, meat, whole grains etc.

Although Vitamin E is used for various ailments, there is strong scientific evidence only for its use in Vitamin E deficiency.

The recommended daily intake for over-14 year olds is 15mg and above 18 years, maximum dose is 1000mg daily. Please be guided by your doctor. However, these doses vary during pregnancy, breastfeeding and specific disease conditions.

Taking Vitamin E in higher doses than recommended may lead to loose, watery stools (diarrhea). Other side effects of Vitamin E intake include nausea, stomach pain, weakness, headache, dizziness, fatigue, blurred vision etc.

So, it woulkd appear that you are having symptoms of side effects of Vitamin E. Please see your doctor to discuss this. He may adjust dosage or suggest other course of action(s).

I hope this helps.

Have a good night, everyone 😀

Ever heard of Alzheimer’s disease? It is a condition in which there is memory loss and problems with problem solving skills or thinking. Do you worry that you may be losing your memory? You can’t remember where you parked your car? That can happen to anybody 😀 But not remembering what car keys are for? Now, that’s a different issue! Okay, here are some lifestyle tips that could stop you from going down the slippery slope of Alzheimer’s disease.

Please click on the link below for more details:

http://www.health.harvard.edu/alzheimers-and-dementia/what-can-you-do-to-avoid-alzheimers-disease?

In Africa, most of our foods are starchy. How does one find good and cheap proteins that can help one keep eating healthy? Is rice and beans a good combination? What of beans and corn? How do I eat healthy without breaking the bank?

The book, Just For The Health Of It With Dr Ketch, explores these and other issues. Get yourself a copy from any of the underlisted outlets:

1) Laterna Books online shop with nationwide delivery. Just click on this link: https://www.laternabooks.com/laterna_product_details.php?v=15450&c=44

2) Another option for those in Lagos is Laterna Bookshop on 13, Oko-Awo Close, Off Adetokunbo Ademola Street,. Victoria Island.

3) If you’re outside the country, please visit Amazon through this link http://www.amazon.com/Just-Health-Ketch-Pregnancy-Parenting/dp/9789398026/ref=sr_1_1?s=books&ie=UTF8&qid=1426246647&sr=1-1&keywords=just+for+the+health+of+it+with+dr+ketch+olalere+nkechi

4) For those in Abuja and environs, please call 07030739403 or pick it up at No 5 Bricks Market, Dawaki 11 Market, Dawaki extension.

5) For those in Awka, please call 08189944090.

Have a great week ahead, y’all 😀

Q: Hi doc I am from Kenya. I had a 3° hemorrhoid removed .I had been suffering from the hemorrhoid for the last 7 years. Now that it has been removed I am sore, going to the toilet is a nightmare that I dread. Could you please give me some tips on how to ease the pain?

A: Haemorrhoids, also known as piles, are swollen veins in the anal canal. They can be internal, external or both internal and external can co-exist. Internal haemorrhoids occur when veins swell within the rectum and external haemorrhoids are found under the skin around the anus.

These haemorrhoids develop when there is undue pressure in the pelvic and anal area as can occur when people strain to pass faeces (if they have diarrhoea or are constipated), in pregnancy (especially the last 6 months), in obese people, people who eat diets low in fibre and people who practice anal intercourse. When women strain in labour, haemorrhoids can also be made worse. For those who love to visit the toilet with their newspapers and spend ages reading them in there, well, you’ve got breaking news! 😀 Sitting on the toilet seat for prolonged periods can also cause haemorrhoids. As people grow older, the support structures for these veins also grow weaker…naturally 😀

Some internal haemorrhoids can be small veins which stay within the rectum. Usually these internal haemorrhoids, stay inside the anus causing no problems. Other internal haemorrhoids can be big veins that sag and protrude out of the anal canal. Straining would cause their delicate surfaces to bruise and bleed. Sometimes, the straining is sufficient to cause the haemorrhoids to protrude out of the anal canal. This is probably what has been described above in the question. When the haemorrhoids are compressed by anal muscles, the pain is made worse and the pressure can lead to cutting off of blood supply to the haemorrhoids.

External haemorrhoids can clot due to irritation forming a hard, painful lump under the skin around the anus.
People with haemorrhoids will complain of streaks of blood in the stool after stooling, blood on the tissue after cleaning up, anal pain, anal itching or a lump around the anus.

Treatment involves the use of ointments to relieve pain, inflammation and itching. There are other minimally invasive and surgical options available that range from rubber band ligation to surgical removal of the haemorrhoids.
Now, for tips to help reduce your pain:

You can limit the discomfort you have by keeping the anal area clean, using wet wipes (non-perfumed) to clean up after using the loo, sit on a bowl of plain warm water for about 15 minutes about twice or three times per day )sitz bath) and also use some pain relief, if in pain.

Ensure that your diet has sufficient amounts of fruits and vegetables. Remember that if you take a regular flat plate, half of this should be filled with fruits and vegetables, half of the plate with complex carbohydrates and the last half with proteins.

Limit the time you spend sitting on the toilet seat (read your newspapers elsewhere :D), use the toilet as soon as you feel pressed (that way the fluid in the stool is not absorbed making the stool hard) and then don’t strain when you do go. Drink sufficient quantities of water daily, exercise (to keep everything moving along nicely :D)

I hope this helps.

Have a great weekend, y’all 😀